Face Masks/Coverings When Attending the Surgery
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:
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:
All patients over 18 years can book their Covid vaccination online at any mass vaccination site or call 119 for advice.
Herts & West Essex Healthier Future website https://covid.healthierfuture.org.uk/ provides useful information.
Oxford AstraZeneca vaccine
New guidance has been issued for the use of the Oxford AstraZeneca Covid-19 vaccine.
This follows further reviews by the independent regulator, the MHRA, and the Commission for Human Medicines, of a very small number of people in the UK who have developed a rare blood-clotting condition since having the Oxford AstraZeneca Covid-19 vaccine.
The MHRA and Joint Committee for Vaccinations and Immunisations have emphasised that the risk of this condition is extremely small and that the benefits of the vaccine outweigh the risks for the vast majority of people. They have recommended that:
· Everyone who has had the AstraZeneca vaccine should still have a second dose of the AstraZeneca vaccine, irrespective of age, unless they have had a blood clot or have an existing risk of thrombosis (blood clotting)
· People aged 30 and over or who have a health condition that puts them at higher risk of severe Covid-19 disease should still be offered the Oxford AstraZeneca vaccine. The benefits in protecting them against the serious consequences of COVID-19 outweigh any risk of this rare condition.
· People aged 18-29 who do not have a health condition that puts them at higher risk of severe Covid-19 disease will be offered an alternative Covid-19 vaccine where available. (This has been recommended as a precaution as people under 30 are at less risk from Covid-19 and not because they are considered to be at particular risk of developing the rare blood clot.)
· People under 30 can still choose to have the Oxford AstraZeneca vaccine if this will mean they can be protected more quickly and they have been made aware of the guidance.
Please see the leaflet below that has been produced by Public Health England and the NHS to answer any questions you may have
Benefits and risks of the vaccination
|Age||Risk from COVID-19||Benefit of vaccination||Risk of vaccination|
|Over 50 years of age or having underlying medical conditions||Low – catching infection, passing on infection||1 dose – more than 80% reduction: deaths, hospitalisation, intensive care||Uncommon – sore arm, feeling tired, headache, general aches, flu like symptoms|
|Moderate – Long COVID||2 doses – more than 95% reduction: deaths||Extremely rare – clotting problems|
|Very high – hospitalisation, intensive care admission, death|
|30 to 49 years of age||Low – hospitalisation, intensive care admission, death||1 dose – between 60% and 70% reduction: catching infection, passing on infection||Common – sore arm, feeling tired, headache, general aches, flu like symptoms|
|Moderate – Long COVID||2 doses – more than 85% reduction: catching and passing on infection||Extremely rare – clotting problems|
|High – catching mild infection, passing on infection|
|18 to 29 years of age||Very low – hospitalisation, intensive care admission, death||1 dose – between 60% and 70% reduction: catching infection, passing on infection||Very common – sore arm, feeling tired, headache, general aches, flu like symptoms|
|Moderate – Long COVID||2 doses – more than 85% reduction: catching and passing on infection||Extremely rare – clotting problems|
|Very high – catching mild infection, passing on infection|
What to look out for after vaccination
Delivering your COVID-19 vaccination
As you will by now know, the COVID-19 vaccination programme has been rolled out for all patients over the age of 18 years. Please book your vaccination online at any mass vaccination site.
Please take a look at the COVID vaccination priority poster for more information about who will get the vaccine and in what order. There is also information about the vaccination in this leaflet.
If you are not on the priority list or are unsure about when you will be called for a vaccination, please take a look at this leaflet which explains why you may have to wait a while.
Across West Essex our Primary Care Network (PCN) is working with the local authorities to make sure people in our area have access to the vaccine.
|1||Residents in a care home for older adults and staff working in care homes for older adults|
|2||All those 80 years of age and over and frontline health and social care workers|
|3||All those 75 years of age and over|
|4||All those 70 years of age and over and clinically extremely vulnerable individuals (not including pregnant women and those under 16 years of age)|
|5||All those 65 years of age and over|
|6||Adults aged 16 to 65 years in an at-risk group (see below)|
|7||All those 60 years of age and over|
|8||All those 55 years of age and over|
|9||All those 50 years of age and over|
|10||Rest of the population (to be determined)|
Please do not book a GP appointment or attend your practice if you have symptoms associated with coronavirus, including a new continuous cough, a high temperature of 37.8 degrees centigrade or higher or loss of taste or smell (anosmia).
You are advised to stay at home for 10 days from the onset of cough, fever or loss of taste or smell (anosmia) if you are unwell yourself, and for 14 days from the onset of cough, fever or loss of taste or smell (anosmia) of any other member of your household if you have no symptoms yourself.
If your symptoms are serious, or get worse, NHS 111 has an online coronavirus service that can tell you if you need further medical help and advise you what to do:
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 14 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:
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.
Shielding is a practice used to protect extremely vulnerable people from coming into contact with coronavirus. Patients who have been identified as extremely vulnerable have been sent shielding letters by NHS England. we have been asked to help ensure that only patients meeting this strict criteria receive these letters, otherwise we risk large numbers of less vulnerable people competing with these extremely vulnerable groups, for the limited amount of extra support being offered to them, by various organisations.
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:
For COVID-19 Symptom checker
General information on COVID-19
Asthma UK support for COVID-19
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.
We have stopped offering online appointments for the remainder of the month 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.
Electronic Prescription 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.
General Practice Transparency Notice for GPES Data for Pandemic Planning and Research (COVID-19)
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:
Radiology Reduction in Opening Times
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
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.
NHS Volunteer Responders
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:
CQC COVID-19 Emergency Support Framework
The Care Quality Commission is not routinely inspecting services during the COVID-19 pandemic and are maintaining contact with surgeries through existing monitoring arrangements and engagement and support calls. Please see further information in the Summary Record below:
Your COVID Recovery
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.