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Found 21 results
  1. Content Article
    Consider your balance between remote and face to face care – have you got it right and how might it need to change in the months to come? Think about how you are going to manage respiratory symptoms over the winter and be aware of the issues with COVID-19 in children and what to do if resuscitation is needed.Shielding is paused and is unlikely to return in the same form as at the start of the pandemic.Know about the standard operating procedure (SOP) for primary care Appraisal is restarting in a very light-touch way and there are other changes to administration.Continue to wear PPE when seeing patients face to face, and continue planning for a much bigger flu vaccination season than usual. Death certification requirements are relaxed for as long as the Coronavirus Act is in force.Look after yourself and your staff.Continue to plan ahead; this will be a marathon, not a sprint.Your core clinical skills are still important.
  2. News Article
    Lockdown had a major impact on the UK's mental health, including increased rates of suicidal thoughts, according to new research. The study, led by the University of Glasgow, examined the effects of COVID-19 during the height of the pandemic. Certain groups are said to be particularly at risk, including young people and women. This publication is the most detailed examination of how the UK's adult population coped during the first weeks of lockdown, when people were given strict orders to stay home. Researchers say public health measures, like lockdowns, are necessary to protect the general population, but warn they may have a "profound and long-lasting" effect on mental health and will extend beyond those who have been affected by the virus. The study, published in the British Journal of Psychiatry, looked at three blocks of time between March 31 and May 11. Just over 3,000 adults in the UK were surveyed and a range of mental health factors were considered, including depression, loneliness, suicide attempts and self-harm. The study found suicidal thoughts increased from 8% to 10% and they were highest among young adults (18-29 years), rising from 12.5% to 14%. The researchers say that, even though those are relatively small rises, they are significant because of the short period of time they happened over. "The majority of people did not report any suicidal thoughts, but this creeping rise over a very short period of time is a concern," says Prof Rory O'Connor, chair in health psychology at the University of Glasgow's Institute of Health and Wellbeing. Read full story Source: BBC News, 21 October 2020
  3. News Article
    Hundreds of thousands of vulnerable people living in coronavirus hotspots could be told to "shield" this winter as infections continue to rise. Ministers are expected to outline a three-tier local lockdown system next week, which may see those most at risk if they catch COVID-19 being told to stay at home for a month. A decision on shielding has not been finalised and may be delayed because of fears for the mental health of those told to avoid seeing other people. Around 2.2 million people in England deemed "clinically extremely vulnerable" were asked to shield at the height of the coronavirus pandemic before the scheme was "paused" at the end of July. Sky News understands that the level of self-isolation required in each area will vary depending on the restrictions in place there. It is thought the advice will be clinically led, with GPs helping guide what people should do bearing in mind possible negative effects on mental health. This compares with the more blanket advice on shielding last time around. Read full story Source: Sky News, 9 October 2020
  4. News Article
    Having flu and COVID-19 together significantly increases your risk of death, say government scientists who are urging all those at risk of getting or transmitting flu to get the vaccine in the coming weeks and months. The evidence for the double whammy is currently limited and comes mostly from a study with small numbers – 58 people – carried out in the UK during the early phase of the pandemic. “As I understand it, it’s 43% of those with co-infection died compared with 26.9% of those who tested positive for Covid only,” said England’s deputy chief medical officer, Prof Jonathan Van-Tam. These were people who had been hospitalised and had been tested for both viruses, he said, and so were very ill – but the rate of death from Covid alone in the study between January and April was similar to the known rate of Covid hospital mortality generally of around 25% or 26%. "I think it is the relative difference in size of those rates that’s rather more important than the absolute rate,” he said. The study may have been small and they would be doing further studies this season, but the findings tallied with other work that has been done, he said. “If you get both, you are in some serious trouble, and the people who are most likely to get both of these infections may be the very people who can least afford to in terms of their own immune system, or their risk for serious outcomes. So please protect yourself against flu, this year,” says said Prof Yvonne Doyle, medical director of Public Health England The government has bought 30,000,000 doses of flu vaccine, which is more than ever before. They will arrive in batches, so the elderly – over 65 – and those with medical conditions will be called for immunisation first. Relatives of those who are on the shielding list will also be called up. The letters will begin to go out this week. Because of the threat of Covid and the risk that people with flu could be infected if admitted to hospital, all those aged 50-64 will be offered flu vaccination, but not straight away. They should wait to be called by their GP. Read full story Source: The Guardian, 22 September 2020
  5. News Article
    Millions of people who are at risk of serious illness from COVID-19 could be asked to start shielding again if infection rates continue to rise, according to reports. Officials are planning to send out letters telling the most vulnerable either to stay at home or to follow advice specifically tailored to their health conditions. The Daily Telegraph reports that the new programme will initially target those living in areas with dangerous levels of coronavirus but went on to quote an anonymous official as saying it could be applied to the whole of England if necessary. If so, it could affect up to 4.5 million people – more than double the number who were asked to shield at the start of the lockdown in March. The new shielding scheme is reportedly based on a "stratified risk model" which would target individuals based on factors such as their underlying health conditions, age, sex and weight. Read full story Source: 13 September 2020
  6. News Article
    Doctors who have been shielding during the covid-19 pandemic have said they are worried for their safety when they return to work. From 1 August those who are at high risk of serious illness if they contract covid-19 will no longer be advised to shield in England, Scotland, and Northern Ireland.123 But doctors who have been shielding during the pandemic have expressed concerns about their safety when they return to work, and say they feel forgotten by their employers. Read full story (paywalled) Source: BMJ, 21 July 2020
  7. News Article
    The 2.2 million people who have been self-isolating in England during the pandemic will no longer need to shield from 1 August. From 6 July, they will be able to meet up outdoors, in a group, with up to five others and form 'support bubbles' with other households. The measures can be eased because infection rates are falling, the government says. Among the list of people who should be shielding are solid organ transplant recipients, cancer patients undergoing chemotherapy, pregnant women with heart disease and people with severe respiratory conditions such as cystic fibrosis and severe asthma. The government says it has worked with clinicians, GPs, charities, the voluntary sector and patient groups on the changes, but some charities are criticising the relaxing of the advice, saying many of the people they support do not feel it is safe to stop shielding. Read full story Source: BBC News, 23 June 2020
  8. News Article
    Some extremely vulnerable people have been told they have been removed from shielding lists via text message, without the knowledge of their GP. This has caused confusion, with charities demanding clearer guidance for this group as lockdown eases. GPs say they should be notified when their patients are added or removed from the lists. Shielding has now been extended until the end of June and is under constant review, the government says. Around 2.2 million people in the UK are staying at home to protect themselves from the virus because they were told they were at high risk of being seriously ill with COVID-19. But 40 healthcare charities say the lack of a clear plan for their future is causing anxiety and potentially putting their health at risk. Read full story Source: BBC News, 30 May 2020
  9. News Article
    An emergency unit at a Norwich hospital has reduced ward admissions and is helping shield urgent non-COVID-19 patients. The older people’s emergency department (Oped) – a special unit at the Norfolk and Norwich university hospital – is providing emergency care for patients over 80. Launched in 2017, the unit, just down the corridor from A&E, has six beds, two in side rooms and no waiting room. Normally, it admits patients identified as frail and usually with multiple conditions that need a lot of care (such as cognitive impairment, incontinence or reduced mobility). They are brought straight in by ambulance or trolley from other parts of the hospital and seen by a consultant geriatrician within two hours. A team of nurses with experience in both emergency care and care of the elderly, pharmacists and physiotherapists are on hand to support patients much more quickly than A&E to get patients out of hospital and back home within the same day wherever possible. For patients who need to stay longer after treatment there is an adjacent ambulatory ward. This unique model is showing results. The proportion of the specialist department’s patients admitted to the hospital is 50% compared with 68% for the same age group of emergency patients coming to the hospital five years ago, when they were treated at the normal A&E. When Oped patients are admitted, their average length of stay is 1.2 days less. “It’s just what we want for old people,” says Dr Sarah Bailey, the department’s lead consultant geriatrician. “We get the experts in straight away because we recognised that’s the best thing for [them]”. During the pandemic, the unit is helping to keep those who do not have coronavirus symptoms, such as those with injuries from falls and some stroke patients, away from the main A&E ward, providing a degree of shielding not normally possible. But for most NHS trusts, providing a separate unit like Oped is not feasible. “Hospitals are working to separate emergency patients with respiratory problems from those with other conditions,” says Dr Jay Banerjee, who leads the Royal College of Emergency Medicine’s work on emergency care for the elderly. “But most just do not have the capacity to also try to separate elderly patients with other conditions from younger patients.” Read full story Source: The Guardian, 27 May 2020
  10. News Article
    NHS England has set up an advisory group to look at how physical and mental health services can be delivered to patients who are most vulnerable to COVID-19 and have been asked to shield themselves from the pandemic. There are now around 2.5 million patients on the list of people considered to be at the highest clinical risk, including solid organ transplant recipients and patients on chemotherapy, who have been told to cut themselves off from society as far as possible. They are going to have to stay that way beyond the end of June, with suggestions that their isolation could continue for many more months hence, and there is significant concern about the impact of this on their ongoing physical and mental health. The NHS has therefore set up an advisory group to examine how care can be provided to these patients. Read full story Source: HSJ, 13 May 2020
  11. News Article
    Tens of thousands of cancer patients have not yet received letters advising them to “shield” themselves from the coronavirus threat, The Times has learnt. Peter Johnson, national clinical director for cancer, has written to charities asking for their help in tracing the missing patients and alerting them to the need to take stringent self-protection measures against infection. His appeal comes as the government increased by one million its estimate of the number of people at greatest risk of severe illness should they contract COVID-19. Its new strategy document stated that it had identified 2.5 million people who were “clinically extremely vulnerable and advised to shield”. At the onset of the lockdown in March, ministers estimated the number at 1.5 million. Professor Johnson’s letter, seen by The Times, states: “We are still receiving reports of cancer patients who believe that they should have received a shielding letter but have not yet received one or have not been added to the national list. It is crucial that those who are clinically extremely vulnerable receive a letter advising them to shield. Read full story Source: The Times, 12 May 2020
  12. News Article
    Significant concerns about the NHS’ refusal to share data with councils have emerged in a letter from a leading council chief executive and clinical commissioning group accountable officer. Steven Pleasant, chief executive of Tameside Metropolitan Borough Council and accountable officer of Tameside and Glossop CCG, said the failures are “becoming increasingly exasperating”, in a letter intended for the Ministry of Housing, Communities and Local Government’s shielding sounding board. Steven said he understands NHS Digital has decided the most recent version of the list cannot be shared with councils even though it is being shared with police, fire, voluntary organisations and companies offering logistical support. “I am sure that you will appreciate that this is counterproductive and frustrating given that local authorities are leading and coordinating the response to the most vulnerable in communities,” he wrote. He also raised concerns about how the NHS’ shielded patients team is passing on to councils information about people needing additional support — for instance, if the recipient’s food parcel stock is running low, requiring the council to step in. Welfare concerns and medication information could also need to be passed on. Mr Pleasant said although his council had asked for this information to be provided via email, staff “have been told by the NHS shielding team that they do not have permission to do this and that details can only be provided verbally over the phone”. “We believe this significantly increases the chances of error and presents significant risk… around incorrect information being captured,” he wrote. Read full story Source: HSJ, 21 April 2020
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