Halting of Citizens’ Access mass roll-out is the right thing to do for patients, says BMA - BMA media centre - BMA

Welcome from our new organisation

We are delighted to introduce to you our new organisation, the Hertfordshire and West Essex Integrated Care Board (ICB).

We are the new NHS body responsible for planning and overseeing health services in Hertfordshire and the Harlow, Epping and Uttlesford districts of Essex. The ICB has taken over the functions of Herts Valleys, East and North Hertfordshire and West Essex Clinical Commissioning Groups (CCGs), which formally closed yesterday (30 June).

It's our organisation’s responsibility to make sure health services effectively meet everyone's needs to improve care and health, and take responsibility for spending NHS money wisely. You can learn more about what we do on our new website.

Today is also the launch of the Hertfordshire and West Essex Integrated Care Partnership (ICP), which brings together Hertfordshire and Essex County Councils - the organisations responsible for social care in our area - with the NHS, and a range of public and voluntary sector organisations.

The work of the Essex and Hertfordshire Health and Wellbeing Boards, the insight of the ICP’s member organisations, and input from people and communities will inform a new integrated care strategy, which will be drawn together by the ICP later this year. This strategy will in turn shape the work of our ICB.

We are committed to working together to improve health and care for our 1.5 million residents in the Hertfordshire and West Essex Integrated Care System (ICS). You can read more about the Integrated Care System also on it's new website, where you'll also find more information about the Integrated Care Partnership.

To help mark this momentous day for health and care in Hertfordshire and west Essex, we're delighted to share this first e-newsletter with you, which you have received as a former subscriber to one of the three former clinical commissioning groups’ newsletters.

Through this weekly newsletter, you'll get the latest news from our organisation and our Integrated Care System. We'll let you know of opportunities to get involved as well as local initiatives you may be interested to hear more about, alongside campaigns from nearby and nationally. If you are on social media, follow our Facebook and Twitter accounts for daily posts and latest updates.

In the same way as our ICB will, this newsletter will grow and blossom over the coming months. Thank you to everyone who has taken time recently to feedback on what works well, and how we can improve. We're extremely grateful for your views and we're looking forward to introduce changes over time. There will be future opportunities to feed into the design and content of this newsletter over the coming months too.

Whilst we hope you will continue to find these updates useful and interesting, you can choose to unsubscribe at any point - there will always be a button at the end of our emails to do this. We hope you’ll choose to stay with us, but it’s always up to you.

Thank you for the invaluable role you've played in the work of the Hertfordshire and west Essex CCGs over the years. Your time and input has had a true impact on health and care in our area, and we're looking forward to our future with you as an ICB.

People suffering ‘long covid’ symptoms will be offered specialist help at clinics across England, the head of the NHS announced today.

Respiratory consultants, physiotherapists, other specialists and GPs will all help assess, diagnose and treat thousands of sufferers who have reported symptoms ranging from breathlessness, chronic fatigue, “brain fog”, anxiety and stress.

Increasing medical evidence and patient testimony is showing that a small but significant minority of people who contract Covid cannot shake off the effects of the virus months after initially falling ill. Some estimates suggest that 10% of Covid patients may still be experiencing symptoms more than three weeks after infection, and perhaps 60,000 people could be suffering from long covid symptoms after more than three months.

NHS chief executive Sir Simon Stevens will announce that £10 million is be invested this year in additional local funding to help kick start and designate long covid clinics in every area across England, to complement existing primary, community and rehabilitation care.

Sir Simon said new network will be a core element of a five-part package of measures to boost NHS support for long covid patients:

1. New guidance commissioned by NHS England from NICE by the end of October on the medical ‘case definition’ of longcovid. This will include patients who have had Covid who may not have had a hospital admission or a previous positive test. It will be followed by evidence-based NICE clinical guidelines in November on the support that long covid patients should receive, enabling NHS doctors, therapists and staff to provide a clear and personalised treatment plan. This will include education materials for GPs and other health professionals to help them refer and signpost patients to the right support.
2. The ‘Your Covid Recovery‘ – an online rehab service to provide personalised support to patients. Over 100,000 people have used the online hub since it launched in July, which gives people general information and advice on living with long Covid. Phase 2 of the digital platform being developed this Autumn by the University of Leicester will see people able to access a tailored rehabilitation plan. This will enable patients to set goals for their mental and physical health, provide peer to peer support through social community forums, offer an ‘ask the expert’ facility for patients to contact their local rehab service, and allow patients to be monitored by their local rehab teams to ensure that they are on track with their care.
   This service will be available to anyone suffering symptoms that are likely due to COVID-19, regardless of location or whether they have spent time in hospital. It is most likely that patients will access the service through their GP, but they could also be referred through another healthcare professional following assessment.
3. Designated Long Covid clinics, as announced today. This will involve each part of the country designating expert one-stop services in line with an agreed national specification. Post-covid services will provide joined up care for physical and mental health, with patients having access to:
   – A physical assessment, which will include diagnostic testing, to identify any potential chronic health issues.
   – A cognitive assessment, to assess any potential memory, attention, and concentration problems.
   – A psychological assessment, to see if someone is suffering potentially from depression, anxiety, PTSD, or another mental health condition.
   Patients could also then be referred from designated clinics into specialist lung disease services, sleep clinics, cardiac services, rehabilitation services, or signposted into IAPT and other mental health services.
4. National Institute for Health Research (NIHR) funded research on long Covid which is working with 10,000 patients to better understand the condition and refine appropriate treatment.
5. The NHS’s support will be overseen by a new NHS England Long Covid taskforce which will include long covid patients, medical specialists and researchers.

NHS chief executive Sir Simon Stevens said: “While this is still a relatively new virus, we are learning more about covid with every passing week. It is now clear that long covid can have a major impact on the lives of a significant minority of patients weeks or months after they have contracted the virus. So just as the NHS quickly put in place specialist hospital care for acutely ill Covid patients at the start of the pandemic, now we must respond sensitively and effectively to these new patient needs.”

Professor Chris Brightling, Professor of Respiratory Medicine and Consultant Respiratory Physician University of Leicester and UHL NHS Trust, said: “Following Covid-19 infection, some people have persistent and debilitating symptoms including fatigue and breathlessness known as long covid. Sufferers need a coordinated approach to their care and rehabilitation so this proposed plan is most welcome.

“Long covid research studies are essential in understanding the reasons for the variable consequences of the disease to identify those at risk and to test new treatments.”

The new services will follow the launch of the long covid clinic at University College London Hospital earlier this summer where they have treated over 900 people with long Covid symptoms, including those who were not admitted to hospital with the illness. Patients at UCLH may also be given Cardiopulmonary Exercise Testing (CPET), a 40 minute test which includes patients performing graded exercise on an upright bicycle breathing into a mouthpiece to test lung strength.

UCLH Chief Executive, Professor Marcel Levi, said: “The UCLH post-covid clinic has seen 900 patients since mid May. We support moves to increase access for the growing patient groups with post-COVID-19 symptoms and the efforts to treat and rehabilitate patients who are often young and their quality of life has been seriously impacted. There is a growing need to understand and offer access to care especially when, as a new illness, many struggle to access adequate care through traditional routes.”

In response to the announcement, Ondine Sherwood of LongcovidSOS, said: “LongCovidSOS welcome this announcement from NHS England. We believe that multi-disciplinary clinics are essential for the assessment, treatment and rehabilitation of the huge numbers of people still suffering the effects of COVID-19. We hope that clinical guidance from NICE will ensure that necessary referral pathways are in place and that general practitioners are empowered to treat patients with long covid appropriately.”

Tim Spector, Professor of Genetic Epidemiology at King’s College London (KCL), and lead investigator of the ZOE KCL COVID Symptom Study app, said: “We are glad that the need to help long Covid sufferers has been recognised. Using clinical data from the over four million people who downloaded the COVID Symptom Study app run by ZOE and KCL, we have a unique insight into the long-term problems suffered by COVID-19 patients who didn’t go to hospital. Our data shows us that over one in 10 still have problems a month on and around one in 50 are still suffering after three months. Long covid sufferers experience a broad range of symptoms, which include up to 20 different problems and not just the three ‘classic’ symptoms used for diagnosis. This tells us that this is a multisystem disease that requires a multi-disciplinary approach to treatment.

“The COVID Symptom Study will be working closely with the Royal College of General Practitioners (RCGP) to provide educational materials on all the symptoms. There are plans to provide an early assessment of those at high risk of long covid and severe disease via the app. We will also be providing NHS England with better data for the public on this new disease and working to identify volunteers for early intervention trials. We want to encourage everyone to download and use the COVID Symptom Study app to continue providing the NHS with vital information about this mysterious but devastating disease.”

Health and Social Care Secretary Matt Hancock said: “Long covid can have a huge impact on people affected. So we are doing everything we can to support people who are still suffering with effects on their health.

“Since May, rehabilitation facilities and recovery services have been available to those who have suffered with the virus and I am delighted to see these becoming more accessible with the opening of specialist clinics right across England.

“Combined with further research and the new NHS England Long Covid taskforce, these additional services will ensure people get the care they need, improve lives and aid in the fight against this global pandemic.”

British Sign Language (BSL) users can communicate more easily with the emergency services following the launch of a new service this month.

999BSL is a free-to-use video relay service that can be accessed online or downloaded as an app. In an emergency, people who are deaf or hard of hearing can use 999BSL to connect with a BSL interpreter. The interpreter will then call 999 using a landline to relay the conversation to the emergency services operator.

To use the service:

• Open the 999 BSL app or website
• Press the red button to video call
• Communicate with the BSL interpreter

Superintendent Craig Flint, who is the constabulary’s strategic lead for disability, said: “999BSL helps dismantle barriers faced by people who are deaf or hard of hearing by making it easier for them to communicate with the police and other emergency services.

“It is an important step forward in our journey to becoming truly inclusive and as a police force we are continually looking at new ways to make our service more accessible for those living with disabilities.”

For more information visit the 999BSL website.

Police Contact Advice

• Telephone 999 in an emergency where there is a danger to life or a crime is in progress.
• Telephone 101 for non-emergencies where police attendance is required, to report a crime or to report any other incidents.

Safeguarding & Protecting Service Users

We are committed to a best practice which safeguards adults, children and young people, irrespective of their background, and which recognises that a service user may be abused regardless of their age, gender, religious beliefs, racial origin or ethnic identity, culture, class, disability or sexual orientation.