COVID 19 - Vaccine Programme
Headlines last week spoke of “Covid vaccine by Xmas from GPs”. What does this mean for me?
Whilst we certainly would want to be involved in any vaccination campaign, we don’t have any information ourselves yet and contrary to media reports no ‘deals’ have yet been done, but we expect more information soon.
Will you be getting paid to vaccinate us?
GPs hold a contract with the NHS to provide certain services. The money from that contract pays for the building, the heating and electricity, the nurses, receptionists and staff, clinical equipment and a variety of other expenses that go with providing services to patients.
If the government wants GPs to do something new, (e.g. deliver a new vaccine) it will buy that service from the GP to pay for the extra staff, clinics and hours to cover expenses. It is very unlikely that GPs will make a profit out of the Covid vaccine. Based on current information they may make a loss, but recognise that it is the right thing to do for their patients and communities.
But what we don’t know, if what we might have to consider stop doing, to free up time to provide this vaccination service, given that we are working at 150% compared with this time last year, according to our LMC’s survey.
But isn’t it just like a flu jab?
No, not by a long stretch.
Flu jabs are delivered in their own little syringes, and kept refrigerated. They can safely last in a vaccine fridge for several months. We can keep them and use them, either in dedicated flu clinics or opportunistically if we see you for something else. We can run the clinics a bit like a conveyor belt, as I’m sure many of you will have experienced. We can get a large number of people vaccinated in a very short period of time. People then leave the practice immediately. Once a year, job done.
So what’s different about a new Covid vaccine compared with the flu jab?
These new vaccines are not yet ready, and we don’t know when they will be. They are completely different. They need to be stored frozen in special dry ice, colder than a home freezer (about -70°C). Surgeries don’t have those freezers. So they will be delivered whilst they are defrosting for use. However, they can be stored in a vaccine fridge for a few days before expiring. They don’t come in their own little syringes. We will have to carefully draw them up from a main vial, dilute and mix them for each individual, which will probably take from start to finish about 20 minutes, needing two members of staff (one to draw up, one to check - this is established safe practise with these preparations to minimise error). Once the patient has received their Covid-jab they must wait for 15 minutes to ensure no serious reaction -these vaccines are brand new, and whilst there is a huge regulatory framework to ensure their safety, we will have to take extra care. This in itself will be difficult as we have to maintain social distancing and we don’t know how quickly these clinics will take place. It will be nowhere near as quick as a flu clinic.
Will this be at my local GP surgery?
To begin with, NHS England thinks that areas will have one central Covid-jab centre. This might be in a local practice. It might be yours, it might not. You may have to travel. How the chosen centre will continue to look after its patients ongoing and urgent health needs, we don’t yet know. No details of those plans have been shared yet.
Is it just one jab?
No. You will need two. They will be 3-4 weeks apart but you must not have had any other vaccinations in the previous week.
How many patients will get it the vaccine when it’s ready?
Government says it wants 40 million people vaccinated (that’s 80 million appointments). Putting that into context, every year there are 40 million A&E attendances and 360 million GP appointments. This is going to take a long time. There are no spare GPs or practice nurses. We don’t yet know how we are going to plan for this on top of what we are doing now - managing hundreds of acute and chronic patients every day: on the phone, over video and being brought into the surgery by invitation.
Will it be available by Christmas?
No one knows. But if it is, there will be a very small number of doses and we think the Government might suggest protecting Care Home residents first.
Whatever you read in the paper or online, don’t forget - this is going to be very difficult. We need to make sure there is a safe system and a safe vaccine first.
Even when it comes, it won’t prevent Covid, it will only make its effects milder. So please bear with us - we are in the dark too.
And there is still every reason to think ‘Hands, Space, Safe’ for a long time to come.
SEASONAL FLU VACCINATION CLINICS 2020
THE RIVERSIDE PRACTICE
would like to invite their patients
who are “ELIGIBLE” for the flu vaccination
to contact the surgery to make an appointment.
Patients over 65yrs of age - or Patients between 18-64yrs of age within an "At Risk" group
Seasonal flu vaccinations are offered free of charge to our patients who are in an ‘At Risk Group’ these consist of;
- People aged 65 or over
- All pregnant women
- People with a serious medical condition such as:-
- Chronic (long term) respiratory disease
- Obstructive pulmonary disease (COPD) or bronchitis
- Chronic heart disease, such as heart failure
- Chronic kidney disease at stage 3,4 or 5
- Chronic liver disease
- Chronic neurological disease such as Parkinson’s or Motor Neurone disease
- A weakened immune system due to disease such as HIV/AIDS
- Treatment (such as cancer)
- Morbid obesity (adults with a body mass index >40kg/m2
- Also people living in long-stay residential care homes or other long stay care facilities
- People who are in receipt of carers allowance or those who are the main carer of an older or disabled person whose welfare may be at risk of the carer falls ill.
EXTENDED FLU VACCINATION PROGRAMME
As advised by Public Health England, free vaccinations will be made available for people aged 50 to 64, this is expected to be implemented during November 2020 and once vaccinations of the most ‘at-risk’ groups are underway, the Department of Health will confirm when to open the programme to people aged 50 to 64.
The NHS will contact people directly, including information about where to go to get the vaccine.
The expanded flu vaccination programme is part of plans to ready the NHS – both for the risk of a second peak of coronavirus cases, and to relieve winter pressures on A&E and emergency care.
We will no longer prescribe sedating drugs for Fear of Flying
Fear of Flying Policy
Due to a medical safety alert from Aviation trained doctors; we have taken the decision to no longer prescribe sedating drugs such as Diazepam, which is sometimes used to treat fear of flying, and medications such as Zopiclone, which is used as a sleeping tablet. There are several very good reasons why prescribing these drugs is not recommended:
1 – Diazepam and Zopiclone are both sedative, which means it makes you more relaxed and sleepier. If there is an emergency during the flight, it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences not just to yourself, but to those around you.
2 – Sedative drugs can make you fall into an unnatural non-REM sleep. This means you won’t move around as much as you would do in natural sleep. This can cause you to be at increased risk of developing a blood clot in the leg (DVT) or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than 4 hours.
3 – Whilst most people find Diazepam sedating, a small number have paradoxical agitation and increased aggression. It can also cause disinhibition, leading you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers. A similar effect can be seen with alcohol, which has led to passengers being removed from their flights. It could also get you into trouble with the law.
4 – The British National Formulary (BNF), the reference guide for prescription of medications by doctors in the UK, states that the use of benzodiazepines is not allowed in treating phobia. Your doctor would be taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health, and not going on a flight.
5 – Diazepam and similar drugs are illegal in several countries. They may be confiscated, or you may find yourself in trouble with the police
Given the above, we will no longer be prescribing Diazepam for flight anxiety or Zopiclone for flight insomnia. We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines. We have provided a number of these below
AccuRX - SMS Text Service & Video Consultations
We are now using Chain SMS to message patients!
Chain SMS is a system which allows us to easily send text messages to patients. It means we can be much more proactive about some communications, messaging you quickly and securely, so you are not waiting around to hear from us!
Some examples of how we might use it...
- Reminders or notifications (e.g. prescription ready)
- Responding to simple queries (e.g. if you had a quick question about your medication)
- Letting you know we tried to call
- Sending you advice at the end of a consultation
Everything we send is saved to your medical record.
The practice name will always be at the bottom of the message. You won't be able to reply to them. Please help us to help you by keeping your number up to date. If you don't want us to contact you in this way please let us know.
**Update your mobile phone number if you want us to contact you**
For more information on the GP IT system suppliers please click on the following link https://digital.nhs.uk/services/future-gp-it-systems-and-services/gp-it-system-suppliers-awarded-contracts#digital-care-services-gp-it-futures-procurement-outcome
We are now using AccuRX Fleming for Video Consultations
Why is my doctor/ healthcare provider using it?
In response to the COVID-19 outbreak, it is safer for everyone to minimise face to face contact where possible. Because of this, video calls can play a useful role in helping keep everyone safe, whilst still providing care.
What if I still want to have a face to face meeting?
If you think there is something that they won't be able to see or do during this, or you are worried that a video call will not be sufficient, you should discuss this with them.
What if I still want to have a face to face meeting?
You don't need to download anything. You will receive an SMS text message with a link to click on, and you will be connected.
You will need:
- A smartphone, either with working Wifi/3G/4G connection
- Your Internet Browser needs to have your phone's microphone and camera enabled (you can see how to alter this in your phone settings here)
- iPhones running older software that has not been updated (iOS 12 and earlier) will need to download the Whereby app to join the consultation)
Is it safe and secure?
Yes. AccuRx take patient safety very seriously - it is at the forefront of everything we do. In order to offer this type of tool, we must prove that we meet numerous standards, which are outlined here.
Is it approved by the NHS?
We are NHS Digital approved. See the latest guidance from NHSX recommending the use of video consultations.
Can my video consultation be recorded? Will my data be stored somewhere?
A unique link will be sent to you for the video consultation. All participants are visible in the consultation, so no third party can 'listen in'. The video and audio communication of the video consultation is only visible to participants on the call, and is not recorded or stored on any server.
Patient Government Support
The government have launched a new website for patients to use in finding out what help they can get if affected by coronavirus. This service is available to all patients who are seeking advice and guidance on the topics such as:
- feeling unsafe
- going in to work
- paying bills or being unemployed
- getting food
- having somewhere to live
- mental health and wellbeing
Get a free NHS test today to check if you have coronavirus
Update on the Government’s shielding policy and implications for general practice
The following link provides questions and answers for patients regarding "Caring for People at Highest Clinical Risk"
COVID 19 - DELAY PHASE
The practice will be implementing the following measures in line with Public Health England Guidance.
We will be implementing a telephone triage service for all patients requesting an appointment, this will start to be implemented from today, Friday 13.03.2020
Where possible will be undertaking all patient care that can be done remotely through remote means, patients will be advised accordingly on what they will be expected to do if action is required
RECEPTION DESK ETIQUETTE
PLEASE RESPECT THE 1 METER DISTANCE BARRIER WHEN SPEAKING WITH OUR RECEPTIONIST.
COVID 19 PATIENT INFORMATION
From today the public are being advised to stay at home (self-isolate) without any testing for COVID-19, regardless of travel history or contact with confirmed cases, if you have:
A new CONTINUOUS cough
High Temperature (37.8 degrees or higher)
Patients should stay at home (self-isolate for 7 days from the onset of symptoms following the current advice .
Have you been to a country or area with a high risk of coronavirus in the last 14 days, or have been in close contact with someone who has?
If, as a patient you are concerned that you may have coronavirus or may have come into contact with someone who has.
The NHS 111 online service has created coronavirus pages that will tell you what you should do based on your particular circumstances.
These can be accessed at: CORONAVIRUS - COVID19
IT IS ESSENTIAL THAT YOU DO NOT LEAVE YOUR HOME OR VISIT THE RIVERSIDE PRACTICE
If you do however, contact the surgery by telephone, the Receptionist will ask if you have travelled to areas at high risk of the Coronavirus such as China, Asia, Northern Italy, Vietnam, Cambodia, Laos, Myanmar in the last 14 days or been in contact with anyone who has.
If the answer to any of these questions is yes, DO NOT visit the surgery, the receptionist will direct you appropriately.
DO NOT VISIT THE PRACTICE
The NHS is well prepared for outbreaks of new infections diseases and has put in place measures to ensure the safety of all patientns and NHS staff while also ensuring services are available to the public as normal.
PREVENTING SPREAD OF INFECTION
There are general principles you can follow to help prevent the spread of respiratory viruses, including:
- wash your hands often - with soap and water for at least 20 seconds. Use an alcohol-based hand sanitiser that contains at least 60% alcohol if soap and water are not available. This is particularly important after taking public transport
- avoid touching your eyes, nose, and mouth with unwashed hands
- avoid close contact with people who are sick
- if you feel unwell, stay at home, do not attend work or school
- cover your cough or sneeze with a tissue, then throw the tissue in a bin. See Catch it, Bin it, Kill it
- clean and disinfect frequently touched objects and surfaces in the home and work environment
- if you are worried about your symptoms, please call NHS 111. Do not go directly to your GP or other healthcare environment
There is currently no vaccine to prevent COVID-19 acute respiratory disease. The best way to prevent infection is to avoid being exposed to the virus.
RESEARCH STUDY for patient with Chronic Obstructive Pulmonary Disease (COPD)
The Bisoprolol in COPD study (BICS)
A study of the beta-blocker bisoprolol in Chronic Obstructive Pulmonary Disease (COPD).
With colleagues in over 100 General Practices and Hospitals around the UK we are carrying out research into COPD. COPD is the term now used instead of chronic bronchitis and/or emphysema. We are interested in finding out if the flare ups (exacerbations) of COPD can be prevented by a drug called bisoprolol that has been used for many years to treat heart problems. We are hoping to recruit people with COPD at risk of exacerbation to take part in a one year study of bisoprolol that involves up to seven assessment visits lasting less than an hour each. The first five assessments take place over a month or so and during these assessments we make sure that we get the right dose of bisoprolol for you. Travel expenses will be paid.
If you have the condition COPD and are interested in taking part and would like more information please contact Tina Goult or Janette Neeld at the practice by phoning them on 01354 661922.
Long-Acting Reversible Contraceptive / Depo-Provera
Would you like the convenience of self-injecting with Sayana Press at home? avoiding the need to make an appointment at the practice for your scheduled Depo-Provera.
Sayana Press: One injection, every 13 weeks
Sayana Press is a Long-Acting Reversible contraceptive (LARC) injection that gives you 13 weeks of effective contraception. There is no need for daily dosing!
The Riverside Practice now offers this service to our eligible female patients.
Why not discuss with Janet Jackson at your next scheduled Depo-provera appointment.
Addenbrookes Hospital - Patient On-line portal "MyChart"
Why use MyChart?
- Your hospital information will be available to you electronically in MyChart:
- upcoming appointments / past appointment details
- current problems / conditions
- clinical correspondence
- vital signs (weight, height,blood pressure, temperature, pulse, respiration)
- test results
- known allergies
- demographic information (name, date of birth, address, GP details).
MyChart is designed to improve communication between you and your clinical teams, and enable you to be more involved and informed about your care by having access to your information.
Please speak with a clinic receptionist or your clinical team for details on how to sign-up to MyChart.
Once you have signed-up you will be able to access your hospital information via MyChart from your smartphone or tablet device (Apple or Android) or from a computer or laptop.
MyChart is compatible with screen readers.
MyChart patient portal
Accessing MyChart through the website
You can log in to your MyChart using this website address: https://mychart.addenbrookes.nhs.uk
Clinic letters will be available to view using this website.
Accessing MyChart using the app
You can download the MyChart app on smartphone or tablet devices (Apple or Android) then choose ‘Cambridge University Hospitals’ when prompted to select a hospital within the app.
If you have any questions about using MyChart you can:
- email firstname.lastname@example.org
- or contact the ‘Patient Support Service’ through the MyChart website.