Noticeboard

NHS 111 (out of hours) 
Once the Surgery is closed you can call NHS 111 when you need medical help fast but it's not a 999 emergency, whatever the time. Calls to NHS 111 are free from landlines and mobiles.

Test Results
You may telephone the surgery for test results Monday to Friday after 11 o'clock.

Cancelling your Appointment
If you are unable to attend an appointment with one of the doctors or nurses, please telephone to cancel your appointment.

By giving us as much notice as you can you are helping us to make sure that someone else is given your slot.

Out of area registration scheme

The out of area registration scheme launched by the government is voluntary and this practice has chosen not to participate at this time. This decision will be reviewed periodically. This means we are not able to register patients living outside our catchment area, regardless of whether they have been registered with us in the past.

COVID-19 (Coronavirus)

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:

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 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.


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:

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.  


Shielding Letters

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:

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.

We have stopped offering online appointments for the remainder of the month in order to facilitate this triage process.


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:

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

 


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
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.

 


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:

CQC Engagement and Support Summary Record


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. 



 
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