FACE MASKS

We need to continue to do what we can to keep people safe from catching Covid-19. One way we can all help with this is by continuing to wear a face-covering in our practice and we are asking all patients to do that, as well as our staff. Keeping our staff safe is essential to keep operating efficiently.

We are also continuing to make sure we don’t have large numbers of patients in our waiting areas and on the premises – again this is about reducing the chance of infection when there are rising rates in the community.

The various measures we have taken, including increased use of personal protective equipment, patients wearing face masks, holding more virtual consultations, social distancing and extra premises cleans have helped protect staff, patients and visitors over the past year. Taking these steps has also enabled us to continue providing many of the non-urgent services that would otherwise have been postponed.

We want to make sure you can all be confident about accessing or visiting local healthcare services safely.

Thank you for your understanding and your cooperation with this – it makes a huge difference.

As per government guidance, all patients should wear face masks or a face covering when attending the surgery in order to help prevent the spread of Covid-19.

A cloth face covering should cover your mouth and nose while allowing you to breathe comfortably. It can be as simple as a scarf or bandana that ties behind the head.

Please note the following groups are exempt:

Children under 11

People with disabilities

Those with breathing difficulties

Anyone travelling with someone who relies on lip reading

For further information please visit the GOV.UK website via the link below:

https://www.gov.uk/government/publications/how-to-wear-and-make-a-cloth-face-covering/how-to-wear-and-make-a-cloth-face-covering

Exemptions for Face Coverings

The government guidance on exemptions for face coverings suggests there is no requirement for evidence for exemption, therefore it is sufficient for an individual to self-declare this. GPs are not in a position to provide individual risk assessments or letters for patients who feel that they should be exempt from wearing a face mask/covering. 

Government advice on the use of face coverings can be found here:

https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-tomake-your-own https://www.gov.uk/guidance/coronavirus-covid-19-safer-travel-guidance-for-passengers#facecoverings 

 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1037877/UKHSA-12222-COVID-19-guide-for-all-CYP-12-17.pdf

Herts & West Essex Healthier Future website https://covid.healthierfuture.org.uk/  provides useful information.

 Please see the leaflet below that has been produced by Public Health England and the NHS to answer any questions you may have

· Leaflet on COVID-19 vaccination and blood clotting

Benefits and risks of the vaccination

What to look out for after vaccination

Although serious side effects are very rare, if you experience any of the following from around 4 days to 4 weeks after vaccination you should seek medical advice urgently:

• a new, severe headache which is not helped by usual painkillers or is getting worse
• a headache which seems worse when lying down or bending over
• an unusual headache that may be accompanied by:
  • blurred vision, nausea and vomiting
  • difficulty with your speech
  • weakness, drowsiness or seizures
• new, unexplained pinprick bruising or bleeding
• shortness of breath, chest pain, leg swelling or persistent abdominal pain

https://111.nhs.uk/covid-19

Only call NHS 111 direct if you cannot go online, or are advised to do so by the online service. This is to enable 111 to respond in a timely manner to those who are the most seriously affected.

In order for the reception team/Care Navigators to triage your query you may be asked for a brief description of your symptoms or the reason for your call. Our senior clinical team will be telephone triaging all appointments.

Please note that during this period it may take longer for your call to be answered.

Travel and contact history are no longer important for diagnosis. If people who have travelled do not have symptoms they do not need to stay at home, regardless of their travel history.

Herts & West Essex Healthier Future website https://covid.healthierfuture.org.uk/ provides useful information

Requests for Doctor’s Notes (the MED3 ‘Fit Note’)

Patients are reminded that Med3 certificates stating they are unfit to work are usually issued if they are not well enough to do any job at all, not specifically their particular job. For this reason, amended duties are often advised when an employer may, in consultation with their occupational health service, be able to offer a different role.

Patients can and should self-certify for the first seven days as normal if they are unfit to work due to having COVID-19 symptoms or a member of their household is exhibiting symptoms. They do not need to contact their GP.

If they, or someone within their household, remain unwell with COVID-19 symptoms rendering them unfit to work after seven days, the current advice is to visit www.111.nhs.uk where there is an online self-assessment tool; the patient may be invited to call 111 and given further advice and a MED3 certificate emailed to them. They do not need to contact their GP.

Patients who are not unwell themselves, but self-isolating for 5 days from the onset of cough,fever or loss of taste or smell (anosmia) in a member of their household, should discuss this with their employer.

Employers are responsible for putting in place arrangements for home/remote working where this is possible. Where it is not, the employee may self-certify which their employer may authorise as per government advice. The online NHS 111 service can also be used to generate certificates for this purpose.

There is no NHS requirement to issue certification to schools or colleges to confirm absence. These organisations must work with parents and students to ensure that any absence is appropriately recorded, obviating the need for a ‘doctor’s note’. They do not need to contact their GP.

For up to date information on self-isolation, sickness certification and general information relating to COVID 19 coronavirus please visit the GOV.UK website:

https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response

These are guidelines published by Public Health England which is led by a team of doctors, so actions taken in accordance with their guidance should be considered as in accordance with medical advice.

What to do if an employee needs time off work to look after someone

Employees are entitled to time off work to help someone who depends on them (a ‘dependent’) in an unexpected event or emergency. This would apply to situations related to coronavirus (COVID-19). For example:

• if they have children they need to look after or arrange childcare for because their school has closed
• to help their child or another dependent if they’re sick, or need to go into isolation or hospital

There’s no statutory right to pay for this time off, but some employers might offer pay depending on the contract or workplace policy.

ACAS has information on their website and can help with specific queries by phone. Please see the website for further information: https://www.acas.org.uk/

The Citizens Advice Bureau is also a useful point of contact for enquiries relating to whether your employer is following the guidance issued to them.

Adjustments at work for vulnerability due to age or other medical risk factors

Employers must take reasonable steps to reduce, but not eliminate, risk. Employers have been advised to identify which work is “essential” and consider using government initiatives such as the Job Retention Scheme to give people time off while non-essential work has ceased. For work that continues, they must facilitate this work being done from home wherever possible, which may involve implementing technological solutions. They should assess the individual risks of each employee and give the highest risk work to the lowest risk employee. This means that if you are in a small team of people all at high risk, and most are at higher risk than you, you may be required to go in to work. If you are in a large team of low risk people, the employee at highest risk would be first to be given the option of remote working. In this way, everybody is working as a team, to shield everybody as much as is practically possible, and shield the most vulnerable members of the team the most.

Employers are encouraged to gather information about your medical problems and current prescribed medications to make these assessments, in consultation with their Occupational Health Service, with reference to the guidelines from Public Health England and the government, that are available online. They should accept this information from you directly in the first instance to reduce the workload of the NHS. However, if necessary, we can provide this information to your employer if they write to us to request it. The information we provide will be a list of your diagnoses and medication. We cannot provide an opinion on what kind of work you may undertake, as we cannot supercede the specialists in Public Health and Occupational Health. We are not in a position to comment on what work is essential within your organisation, and what risks exist for the other employees that are to be taken into consideration. If you feel that your employer has not assessed you correctly, you can take your dispute to the trade union or employment tribunal. 

If an employee does not want to go to work

Some people might feel they do not want to go to work if they're afraid of catching coronavirus. This could particularly be the case for those who are at higher risk. An employer should listen to any concerns staff may have and take steps to protect everyone. For example, they could offer extra car parking where possible so that people can avoid using public transport. If an employee still does not want to go in, they may be able to arrange with their employer to take the time off as holiday or unpaid leave. The employer does not have to agree to this. If an employee refuses to attend work without a valid reason, it could result in disciplinary action.  

What Do We Mean By Extremely Vulnerable?

People falling into this extremely vulnerable group include:

Solid organ transplant recipients.

People with specific cancers:

People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer

People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment

People having immunotherapy or other continuing antibody treatments for cancer

People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors

People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs

People with severe respiratory conditions including cystic fibrosis, severe asthma and severe COPD.

People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell).

People on immunosuppression therapies sufficient to significantly increase risk of infections such as Azathioprine, Mycophenolate (both types), Cyclosphorin, Sirolimus or Tacrolimus.

Women who are pregnant with significant heart disease, congenital or acquired.

NHS England may vary this list and the eligibility criteria periodically in light of new evidence relating to which groups of people are being particularly affected more severely by COVID-19. Certain groups may be added or removed as community transmission rates change to reflect a change in the level of risk. 

Essex Welfare Services

Local authorities are keen to provide welfare support to people who are at increased risk of serious illness but are not in the highest clinical risk registry. We would like to communicate this offer to all eligible people who might not have a support network around them.

If you are aged 70+ OR 18+ and/or offered a flu jab due to a health condition, you may be at more risk from coronavirus. Please follow Government advice. Ask family, neighbours, friends or local community groups to deliver the food and support you need. If you lack such support please register at www.essexwelfareservice.org.uk/support-request or call 0300 303 9988.

 Requests for ‘Rescue Packs’ of Antibiotics and Oral Steroids

We have been inundated with requests from patients to issue a “Rescue Pack” of Antibiotics and Oral Steroids. Many of these requests come from false social media and Facebook advice suggesting anyone with Asthma, COPD, Bronchitis or other lung conditions should contact their GP for the above medication.

The inappropriate use of Steroids and Antibiotics could be harmful to your health.

In our practice, Rescue Packs of antibiotics and steroids are only given to those select patients who have been seen by the Asthma Nurse Specialist or Respiratory Consultants. These patients have been trained on when and how to use their medication and have a Rescue Pack as part of their management plan. At present we are not issuing rescue packs to any other groups of individuals. If you feel that your chest symptoms are not under control and you are worried about COVID-19 symptoms then please go to either of the following websites. If it is not related to COVID-19 symptoms then only in exceptional circumstances contact your GP:

https://111.nhs.uk/covid-19
For COVID-19 Symptom checker

https://www.nhs.uk/conditions/coronavirus-covid-19/
General information on COVID-19

https://www.asthma.org.uk/advice/triggers/coronavirus-covid-19/#Plan
Asthma UK support for COVID-19

https://www.blf.org.uk/support-for-you/coronavirus

British Lung Foundation support for COVID-19

We appreciate that you may be worried, scared and concerned. We understand that many people want to prepare in advance. However, making inappropriate requests takes away our clinicians time in trying to help the most vulnerable and in turn will lead to more people being unwell. Please help us to help you all.

Thank you for helping us to help you. Together we can all try our best to ensure that we all try and stay healthy and well in this time of national crisis.

Changes to our Appointments

As part of precautions being taken by the surgery, as directed by NHS England in regard to the Coronavirus, when you call for an appointment reception staff will ask whether you have a cough, high temperature or loss of taste or smell (anosmia). If so you will need to be triaged by a clinician over the phone who will then decide whether you are fit to attend the surgery. You may be asked to have a negative PCR test before we see you face to face if you have any Covid symptoms.

We have stopped offering online appointments for the time being in order to facilitate this triage process.

Repeat prescriptions will now be dealt with preferably online and sent to a nominated pharmacy electronically. Please download the NHS App via the App Store or Google Play to manage your prescriptions. Please note that during this period it may take longer for your call to be answered.

Our practice is collaborating with NHS Business Services Authority (NHSBSA) which is providing NHS numbers for those patients that may be suitable for electronic repeat dispensing prescriptions. The information is obtained from NHS prescriptions submitted to the NHSBSA. A member of our clinical team will contact these patients soon to explain the benefits of this service.

Almost all of our prescriptions will be processed electronically as this will lead to a more efficient, faster and secure service.

When you are prescribed a medication, the prescription will be sent electronically to the pharmacy you have chosen. You can collect your medicines or appliances without having to hand in a paper prescription.

If you require details of your medicine then it can be issued as a token which has a unique barcode that will be scanned by the pharmacy to download your prescription from the secure NHS database.

Paper prescriptions will continue to be available in very special circumstances, but almost all prescriptions will be processed electronically.

Please see the NHS Website for further details.

This practice is supporting vital coronavirus (COVID-19) planning and research by sharing your data with NHS Digital.

The health and social care system is facing significant pressures due to the coronavirus (COVID-19) outbreak. Health and care information is essential to deliver care to individuals, to support health, social care and other public services and to protect public health. Information will also be vital in researching, monitoring, tracking and managing the coronavirus outbreak. In the current emergency it has become even more important to share health and care information across relevant organisations. This practice is supporting vital coronavirus planning and research by sharing your data with NHS Digital, the national safe haven for health and social care data in England. 

Please see link below for further information:

General Practice Transparency Notice for GPES Data for Pandemic Planning and Research (COVID-19)

Please note that The Princess Alexandra Hospital, St Margaret’s Hospital and Herts and Essex hospital are now no longer able to accept any routine GP direct access plain film referrals.  The department will continue to accept urgent requests at the times specified below:

The Princess Alexandra Hospital:
Location:  Radiology Dept- Area B6, Hamstel Road, Harlow, Essex, CM20 1QX
Monday-Friday 8am-9am & 2pm-4:45pm

Herts & Essex Hospital: 
Location:  Radiology Dept- Haymeads Lane, Bishops Stortford, Hertfordshire, CM23 5JH
Monday-Friday 8:30am-12:30pm & 1:30-4:30pm

St Margarets’s Hospital:
Location:  Radiology Dept- The Plain, Epping, Essex, CM16 6TN
Monday-Friday 8am-4:30pm

A growing reduction of staff in the radiology department owing to self-isolation, an increased acute activity of suspected COVID-19 cases and the government guidance for social distancing has prompted this temporary reduction in service. 

We will update you with any further disruption to services and equally will alert you as to when normal service can be resumed.

All NHS healthcare staff can make requests via NHS Volunteer Responders to refer patients who are considered to be vulnerable and at risk.

You can be referred for the folllowing types of suppport:

A Community Response Volunteer to undertake errands such as grocery shopping and collecting prescriptions.

A Check in and Chat Volunteer who will call you on the telephone to have a friendly conversation and to see if you are OK.

A Patient Transport Volunteer to take you to medical appointments.

For further information and to see whether you are eligible please see the link below:

https://volunteering.royalvoluntaryservice.org.uk/nhs-volunteer-responders-portal/isolating

Your COVID Recovery is an NHS website designed to help people recover from the long-term effects of COVID-19 and support them to manage their recovery. It has information from rehabilitation experts about how to manage ongoing symptoms and health needs at home, and signposts to sources of support. A significant proportion of post COVID-19 patients are likely to have ongoing health problems. How quickly somebody recovers and the problems they have is likely to vary, and this website can help to answer some questions for patients.