Vulnerable Patients

The government recently sent out letters to those who have clinical conditions which are likely to put them at the highest risk of mortality and severe mobidity from COVID-19. This group were advised that they should undergo strict social isolation for at least 12 weeks and include the following people:

• Solid organ transplant recipients
• People with specific cancers
• People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD
• People with rare diseases and inborn errors of metabolism that significantly increase the risk of infection such as (SCID, homozygous sickle cell disease)
• People on immunosuppression therapies sufficient to significantly increase risk of infection
• People who are pregnant with significant hear disease, congential or acquired

The following who were not written to individually have also been asked to take steps to reduce their social interactions in order to reduce the transmission of Coronavirus:

• Aged 70 or older (regardless of medical conditions)
• Under 70 with underlying health condition e.g. anyone who is instructed to get the flu jab as an adult each year on medical grounds
• Chronic (long-term) respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
• Chronic heart diseases, such as heart faliure
• Chonic kidney disease
• Chronic liver disease, such as hepatitis
• Chronic neurological conditions, such as Parkinson's disease, motor neurone disease, multiple sclerosis (MS), learning disability or cerebral palsy
• Diabetes
• Problems with your spleen - for example, sickle cell disease or if you had your spleen removed
• Weakened immune system as the result of conditions such as HIV and AIDS or medicines such as steroid tablets or chemotherapy
• Being seriously overweight (BMI of 40 or above)
• Those who are pregnant

A subset of this group have clinical conditions which are also likley to put them at the highest risk of mortality and severe morbidity from COVID-19. We are starting to help the government identify these patients, but if you feel you have a medical condition that makes you vulnerable to COVID-19 then please register yourself, or ask someone to do it for you at www.gov.uk/coronavirus-extremely-vulnerable and say whether or not you need support.

Please find below a link to the government guidance. This guidance covers the whole of the UK population and not just those who have been sent a letter. www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults

Local support can also be accessed by phoning the Bexley Coronavirus helpline on 020 3045 5398 which is open from 8:00am to 18:00pm. Contact them if you need someone to get shopping, pick up other essentials or give you information, guidance and advice.

Self-Certification for COVID-19

Please do not ask your GP for a sick certificate if you are off work because of Coronavirus. You can apply for an isolation note to send to your employer as proof you need to stay home. You employer can check the validity of an isolation note by using the check an isolation note service.

Parent's Guide for COVID-19

When your child is ill or injured it is very difficult to decide if/when to call your child's GP, NHS 111 or go to Accident and Emergency Department (A&E). During the current situation and while the government is asking everyone to stay at home, it can be confusing to know what to do.

Advice for parents about routine vaccinations during coronavirus

Guidance to keep you safe when attending your vaccination appointment

While coronavirus has put limitations on all our lives, it is important that you or your baby or child still have routine vaccinations. They protect against serious and potentially deadly illnesses and stop outbreaks in the community. We recommend that you [attend/book in for] your next scheduled appointment – see www.nhs.uk/vaccinations for details on when they are due.

Travelling to and from your appointment

When travelling to and from your appointment, please follow guidelines which include travelling by car, bike or on foot if possible, keeping a safe distance from others and washing your hands regularly. For more details, go to www.gov.uk and search ‘staying safe outside your home’.

When attending your appointment

When attending your appointment, we will be putting in place a range of measures to minimise any risk of COVID-19:

• social distancing measures will be observed;

• we may have asked you to attend your appointment at a clinic that is not at your usual venue;

• the appointment may take longer than usual.

Due to the ongoing response to COVID-19, our service may have a reduced number of appointment slots available. If you choose not to attend your appointment, please contact your GP practice. It is always helpful for us to know why so we can help you with any concerns you might have. If you still don’t wish to attend the appointment, it can be offered to someone else.

You must NOT attend an appointment if you or any member of your household are suffering from any of the symptoms associated with COVID-19 or are self-isolating. If this applies to you, please contact your GP practice so that you can reschedule your appointment for a different time.

If you are identified as clinically extremely vulnerable and have been shielding, please contact your GP practice for the latest advice on what to do.

FACE COVERINGS WHEN USING NHS SERVICES

All patients and visitors to NHS services must wear a face covering at all times.  This includes hospitals, community clinics and GP services.  Evidence has confirmed that face coverings can help reduce the risk of transmission if you are suffering from coronavirus, but not showing symptoms.  

Advice for patients who are part of the shielding programme (July 2020)

The UK Government has set out a roadmap for the clinically extremely vulnerable on the future of the shielding programme.

The guidance changed on 6 July and will change again on 1 August.

What are the changes?

Recently, the UK Government advised that you can spend time outdoors, if you wish, with your own household, or if you live alone with another household. Following this, and alongside current scientific and medical advice the UK Government is planning to relax shielding guidance in stages.

From 6 July, the guidance changed so you can meet in groups of up to six people from outside your household – outdoors with social distancing. For example, you might want to enjoy a summer BBQ outside at a friend’s house, but remember it is still important to maintain social distancing and you should not share items such as cups and plates. If you live alone (or are a lone adult with dependent children under 18), you will be able to form a support bubble with another household.

From 1 August, you will no longer need to shield, and the advice will be that you can visit shops and places of worship, but you should continue maintaining rigorous social distancing.

Why is the guidance changing now?

The roadmap has been developed in line with the latest scientific and medical advice and with the safety and welfare of those who are shielding in mind. Current statistics show that the rate of catching coronavirus in the community continues to decrease. On average less than 1 in 1,700 in our communities are estimated to have the virus, down from 1 in 500 four weeks ago.

Unless advised otherwise by your clinician, you are still in the ‘clinically extremely vulnerable’ category and should continue to follow the advice for that category, which can be found here.

We will monitor the virus continuously over coming months and if it spreads too much, we may need to advise you to shield again.

Update on support

If you are in receipt of Government provided food boxes and medicine deliveries, you will continue to receive this support until the end of July.

Local councils and volunteers are also providing support to people who are shielding, to enable them to stay safely in their homes. The government is funding local councils to continue to provide these services to those who need them until the end of July.

What support is available to people who are shielding until the end of July?

Essential supplies

There are a number of ways that those who are shielding can access food and other essentials:

• Make use of the supermarket priority delivery slots that are available for this group. When a clinically extremely vulnerable person registers online as needing support with food, their data is shared with supermarkets. This means if they make an online order with a supermarket (as both a new or existing customer), they will be eligible for a priority slot.

• Use the many commercial options now available for accessing food, including telephone ordering, food box delivery, prepared meal delivery and other non-supermarket food delivery providers. A list has been shared with local authorities and charities.

• A free, standardised weekly parcel of food and household essentials. If you have registered for this support online before 17 July you will continue to receive weekly food box deliveries until the end of July.

• If you need urgent help and have no other means of support, contact your local council to find out what support services are available in their area.

• For anyone facing financial hardship, the government has made £63 million available to local councils in England to help those who are struggling to afford food and other essentials.

NHS Volunteer Responders

Support will continue to be available through the NHS Volunteer Responder Scheme beyond the end of July.

NHS Volunteer Responders can support you with:

• Collecting shopping, medication (if your friends and family cannot collect them for you) or other essential supplies;

• A regular, friendly phone call which can be provided by different volunteers each time or by someone who is also shielding and will stay in contact for several weeks; and

• Transport to medical appointment.

Please call 0808 196 3646 between 8am and 8pm to arrange support or speak to your health case professional for transport support. A carer or family member can also do this on their behalf. More information is available at www.nhsvolunteerresponders.org.uk

Health care

Any essential carers or visitors who support you with your everyday needs can continue to visit unless they have any of the symptoms of COVID-19 (a new continuous cough, a high temperature, or a loss of, or change in, their normal sense of taste or smell).

People in the clinically extremely vulnerable group should continue to access the NHS services they need during this time. This may be delivered in a different way or in a different place than they are used to, for example via an online consultation, but if they do need to go to hospital or attend another health facility for planned care, extra planning and protection will be put in place.

Mental health support

It is normal during these uncertain and unusual times to feel anxious or feel low.

Follow the advice that works for you in the guidance on how to look after your mental health and wellbeing during coronavirus (COVID-19).

The Every Mind Matters page on anxiety and NHS mental wellbeing audio guides provide further information on how to manage anxiety.

In south east London we have developed the Free your mind hub to support people to look after their mental wellbeing.

If you feel you need to talk to someone about your mental health or you are looking for more support for someone else, we would urge you to speak to a GP and seek out mental health support delivered by charities or the NHS.

Income and employment support

At this time, people who are shielding are advised not to go to work. This guidance remains advisory.

Those shielding will be eligible for Statutory Sick Pay (SSP) on the basis of their shielding status until the 31 July. SSP eligibility criteria apply

From 1 August, if clinically extremely vulnerable people are unable to work from home but need to work, they can, as long as the business is COVID safe.

The Government is asking employers to work with them to ease the transition back to a more normal way of life for their shielding employees. It is important that this group continues to take careful precautions, and employers should do all they can to enable them to work from home where this is possible, including moving them to another role if required.

Where this is not possible, those who have been shielding should be provided with the safest onsite roles that enable them to maintain social distancing.

If employers cannot provide a safe working environment, they can continue to use the Job Retention Scheme for shielded employees who have already been furloughed.

What support will be available after July?

From 1 August, clinically extremely vulnerable people will continue to have access to priority supermarket delivery slots if you have registered online before 17 July for a priority delivery slot.

NHS Volunteer Responders will also continue to offer support to those who need it, including collecting and delivering food and medicines.

The NHS Volunteer Responders Scheme has been expanded to offer a new Check in and Chat Plus role. This new role has been designed to provide peer support and companionship to people who are shielding as they adapt to a more normal way of life.

If you are vulnerable or at risk and need help with shopping, medication or other essential supplies, please call 0808 196 3646 (8am to 8pm).

Government is committed to supporting local councils and voluntary sector organisations to respond to those who have specific support needs and requirements during the COVID-19 pandemic. Details of the support and advice available can be found here: https://www.gov.uk/find-coronavirus-support

The updated shielding guidance should not affect any social care or support you were receiving prior to the start of shielding.

Individuals should continue to contact their local council if they have any ongoing social care needs.

Keeping you safe when you visit the NHS in south east London

The NHS is working hard to make sure that when you come in for your appointment or treatment, everything is done to protect you from the Covid-19 virus – from new social distancing measures and our staff wearing the right personal protective equipment through to enhanced cleaning measures. We’re doing everything we can to keep you safe whilst you’re in our care – so please keep your appointments and get the help that you need now.

We are letting you know about a very useful website called Germ Defence which was created by a team of doctors and scientists to give you advice that has been proven to reduce the spread of viruses in the home. It can help you plan how to protect yourself and members of your family from infection by COVID-19 and flu. 

It's easy to use and only take 10 minutes - just click on this link;

www.germdefence.org/index.html?src=G83047

(if this link does not open when you click on it, please copy and paste it into your web browser)

Please pass details of the Germ Defence website to your friends and family. 

There is  a button at the bottom of the Germ Defence website for sharing by social media. 

If you'd like to know more:

• Over 20,000 people previously took part in research about Germ Defence
• People who followed the advice in Germ Defence had fewer and less severe illnesses and so did the people who they lived with
• Results of the study were published in The Lancet medical journal
• Germ Defence has been updated with COVID-19 advice to help prevent a wave of COVID-19 and flu this Autumn/Winter
• Information about how the Germ Defence website is being evaluated is available here. 

COVID-19 Vaccine: The NHS will get in touch when it’s your turn to be vaccinated – please do not contact the Surgery before then

COVID-19 VACCINE: IMPORTANT INFORMATION

The COVID-19 vaccine is currently being offered to the following:

• people aged 45 and over
• people at high risk from coronavirus (clinically extremely vulnerable)
• people who live or work in care homes
• health and social care workers
• people with a condition that puts them at higher risk (clinically vulnerable)
• people with a learning disability
• people who are a main carer for someone at high risk from coronavirus

If you are a patient of our GP practice and eligible for a COVID vaccination, we will contact you directly, alternatively you can book your vaccine online at www.nhs.uk/covid-vaccination or call 119 without needing an invitation. If you are eligible to use this service but cannot get an appointment, please contact the GP surgery.

Unpaid carers can get the vaccine through their GP, and social care workers can book their vaccine through their employer or GP.

See the full list of priority groups here, and guidance on frontline health or social care workers, and the high and moderate risk categories here.

If you have any questions about the vaccine, please visit the South East London CCG COVID-19 vaccine site, where you will find a comprehensive list of frequently asked questions and answers.

REPORTING COVID-19 SCAMS
NHS Digital continues to respond to several ongoing spam email and SMS campaigns seeking to exploit the ongoing UK coronavirus vaccination efforts. Find out how you can report a scam