Letter from our doctors to our patients

Letter from our doctors to our patients – please click here

The NHS in England and Public Health England (PHE) are well prepared for outbreaks of new infectious diseases. The NHS has put in place measures to ensure the safety of all patients and NHS staff while also ensuring services are available to the public as normal.
 
The latest information on symptoms of coronavirus can be found on nhs.uk/conditions/coronavirus-covid-19/
 
Stay at home if you have coronavirus symptoms
Stay at home for if you have either:

  • a high temperature – you feel hot to touch on your chest or back
  • a new, continuous cough – this means you’ve started coughing repeatedly
  • Loss of sense of smell or taste

Do not go to a GP surgery, pharmacy or hospital.
You do not need to contact 111 to tell them you’re staying at home.
Testing for coronavirus is not needed if you’re staying at home.
RECENT HEADLINES
Recent texts/letter about 12 Week isolation for At Risk Groups
Who is at high risk? You may be at high risk from coronavirus if you:

  • have had an organ transplant
  • are having certain types of cancer treatment
  • have blood or bone marrow cancer, such as leukaemia
  • have a severe lung condition, such as cystic fibrosis or severe asthma
  • have a condition that makes you much more likely to get infections
  • are taking medicine that weakens your immune system
  • are pregnant and have a serious heart condition

Information:
If you’re at high risk, you will be contacted by the NHS by Sunday 29 March 2020. Do not contact your GP or healthcare team at this stage – wait to be contacted. GPs do not have any other information than is available on the NHS website.
 

Guidance notes for patients requesting exemption letters for Face Coverings
We are aware that some patients might be understandably anxious about the Government’s recent announcements around the use of face masks in various public settings.
 
Some people don’t have to wear a face covering including for health, age or equality reasons. Some transport staff may not wear a face covering if it is not required for their job.
 
Your GP is 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.
 
The government guidance on exemptions suggests there is no requirement for evidence for exemption therefore it is sufficient for an individual to self-declare this. The responsibility for issuing exemptions lies with the transport provider not your GP. Similarly, practices are under no obligation to provide letters of support for anyone who does not fall under the list of exemptions but considers them to have another reason to be exempted.
 
Government advice on the use of face coverings can be found here – there is also a useful website which gives clear guidance has exemption cards embedded you can use for self-declaration :
https://www.gov.uk/guidance/coronavirus-covid-19-safer-travel-guidance-for-passengers#face-coverings
https://www.keepsafe.org.uk/mask
 
Leicester, Leicestershire & Rutland Local Medical Committee has therefore prepared this guidance note as the statutory body that advises and supports all GPs and practice teams across both counties.

Rescue Medication for Asthmatics and COPD patients


Despite recent media discussion on Facebook etc. guidance states that there is usually no need for asthmatics to have Rescue medication packs. The only group of patients requiring these is patients who have Chronic Obstructive Pulmonary Disease (COPD) with a breathless scale of 3 or greater.  GPs at this time are generally NOT issuing anyone outside of this group with rescue pack medication.
Up to date information can be found at: https://www.gov.uk/coronavirus

If you have questions about inhalers for your Asthma please read this first.

Additional useful links

New easy read information about Coronavirus

We have been working with Public Health England to make some easy read information about Coronavirus (sometimes called COVID-19).

Coronavirus is a new illness that can affect your lungs and your breathing.

This easy read information tells you about 5 things that everyone can do to help stop you and other people getting Coronavirus.

You can read the easy read information about Coronavirus

You can also watch The Hand Washing Rap – a video about washing your hands from Purple All Stars.

Or read this easy read poster from Photosymbols

Emotional wellbeing

For details of organisations and helplines – please click on the following link
https://www.gov.uk/government/publications/covid-19-guidance-for-the-public-on-mental-health-and-wellbeing/guidance-for-the-public-on-the-mental-health-and-wellbeing-aspects-of-coronavirus-covid-19

Coronavirus testing for patients

Anyone aged 5 and above who has symptoms can now get tested, using a swab test, to see if they currently have coronavirus. Essential workers will be given priority and appointments must be made in advance.

For patients in Leicester, Leicestershire and Rutland, the test could take place either at our permanent test centre at Birstall Park and Ride or at a mobile testing unit (MTU). Mobile units are only in a location for a few days. They have an integrated one-way system that allows people with an appointment to attend for either walk-in or drive through testing. There is also a permanent site in Peterborough that might be of interest to patients in Rutland.
 
The swab test is only effective if it is carried out in the first three to five days of symptoms, therefore it is important that patients book their appointment as soon as they develop symptoms as it may take time to arrange.
 
To avoid people turning up at the MTUs without an appointment and to reduce the risk of people delaying their test for a more convenient location, specific location details and the duration of an MTU’s stay are not being made available to the general public. When people book their appointment they will be given a choice of local locations from the permanent sites and the MTUs that are in operation at the time. They will receive the full address details of where to go with their confirmation email.

The key messages for patients are:

  • If you have symptoms, arrange to get tested straight away at any one of the local sites. Don’t wait for one to come to your town.
  • Appointments must be booked in advance: https://www.gov.uk/guidance/coronavirus-covid-19-getting-tested. Anyone who doesn’t have access to the internet can call 119. The service can be accessed by people with hearing or speech difficulties by calling 18001 0300 303 2713.
  • The new NHS Test and Trace service will now make contact with anyone who has tested positive for coronavirus to ask them to share the details of anyone they have been in recent close contact with. This is so they can be given advice about getting tested themselves and self-isolation.

Update on antibody test kits for home use:

Some UK providers such as high street pharmacies and private healthcare providers offer COVID-19 antibody testing for members of the public. The test involves taking a finger prick blood sample. The laboratory tests are CE marked and safe for use on blood drawn from the vein by a healthcare professional, but have not yet been validated by the manufacturer of the test to be used with a finger prick blood sample.

It’s very important for people at home to be able to understand the reliability of the result and what it means for them. A positive result may not mean a person is immune or if they demonstrate immunity now, or how long this will last.

The Government strongly advises members of the public or organisations who have purchased these tests and received antibody results to continue to follow the Government’s advice whatever the result of the test. It’s also important to know that GPs can’t provide a patient with an in house Blood Tests for use with a privately purchased antibody test.

The Government is contacting providers of the antibody testing services and the laboratories running these tests to ask them to temporarily stop offering these tests for sale until the regulatory and safety concerns have been resolved.

Link to the national track and trace guidance

Shielding patient support

People who have been advised to shield can ask volunteers for short-term help by calling 0808 196 3646 between 8am – 8pm.

Guidance for Extremely Vulnerable Patients who are Shielding
You will have seen that the Government has updated the guidance for people who are clinically extremely vulnerable to Covid 19 and have been advised to shield. The update from Government comes into effect from today. In summary the changes are:

  • The advice for people identified as clinically extremely vulnerable is that they should continue to shield until at least the 30 June but from 1 June, they can spend a short period of time outdoors each day with members of their household, still maintaining 2m distance from others.
  • If the shielded person lives alone, the Government is advising they can meet one other person from a different household, maintaining strict social distancing. The advice is that this be the same person each time.
  • Important aspects of Governments policy and guidance remain the same. Apart from going outside once per day, a shielded person should continue to avoid all non-essential face to face contact. This means they should still not go shopping or to pharmacies.
  • The support for shielded people remains in place and unchanged.
  • The Government has also confirmed that it will be reviewing shielding guidance alongside wider changes to social distancing, including plans to write to those on the shielding patients list with information about next steps on shielding after the next review on 15 June.

Further update
Managing Shielded Patients in LLR Update 5/6/20

  • You will have seen that the Government have updated the guidance for people who are clinically extremely vulnerable to Covid 19 and have been advised to shield. The update from Government comes into effect from the 1st June 2020. In summary the changes are:
     
  • The advice for people identified as clinically extremely vulnerable is that they should continue to shield until at least the 30 June but from 1 June, they can spend a short period of time outdoors each day with members of their household, still maintaining 2m distance from others.
  • If the shielded person lives alone, the Government is advising they can meet one other person from a different household, maintaining strict social distancing. The advice is that this be the same person each time.
  • Important aspects of Government’s policy and guidance remain the same. Apart from going outside once per day, a shielded person should continue to avoid all non-essential face to face contact. This means they should still not go shopping or to pharmacies.
  • The support for shielded people remains in place and unchanged.
     
    The Government has also confirmed that it will be reviewing shielding guidance alongside wider changes to social distancing, including plans to write to those on the shielding patients list with information about next steps on shielding after the next review on 15 June. 
     
    Therefore over the coming weeks as part of the Restore and Recovery practices and PCNs will need to consider how these patients are managed beyond the 30th June. The temporary home visiting service provided by LPT is due to end in line with the current government advice on shielding (30th June 2020). For the period of May 2020 there have been 245 patient contacts across LLR.

Shielding Update 26/6/20
Government has announced that from Monday 6 July, the advisory guidance for clinically extremely vulnerable people who are currently shielding will be eased, and that they will be able to gather in groups of up to six people outdoors and form a ‘support bubble’ with another household. The chief medical officer and NHS medical director have issued a new shielding update letter to the NHS, including for GPs.
 
The Government is writing to those on the shielded list to make them aware of the updated guidance, advising them to continue with whatever care/treatment arrangements are currently in place. Patients will also be advised that NHS England may ask GPs to review the care arrangements when the shielding advice is further relaxed from 1 August. The NHS will continue to maintain the Shielded Patient List in order to maintain targeted advice and support to those who are most vulnerable
 

Facemasks

Following the release of government guidance regarding the wearing of face masks in various public settings (including the circumstances where an individual might be exempt), practices are reporting increases in requests from patients for letters of exemption.

The government guidance on exemptions suggests there is no requirement for evidence for exemption, therefore it should be sufficient for an individual to self-declare this and Practices are not required to provide letters of support for those who fall under the list of exemptions. The responsibility for issuing exemptions is with the transport provider, not GPs – for example, this information from First Bus and Arriva.

N/B: It is still mandatory for patients to wear face covering whist on the surgery premises.