COVID-19 Information

Many people with a learning disability and/or autism will become increasingly vulnerable and isolated during the current Covid-19 crisis.

In response to this, the new ‘Keeping People with a Learning Disability and/or Autism Connected” project has been launched with a focus on people who are routinely not known to services or accessing support. It is co-ordinated by Inclusion North, Humber Transforming Care and Healthwatch North Lincolnshire. It aims to help people by keeping them connected during this current climate.

Our call handlers will assess how safe a person is, what additional help they may need, and then support them to access this help. They will receive calls from specialist staff that will support them with understanding information relating to Covid 19, talk through their worries and offer reassurance.

We will also signpost them to local services to be able to access support with any practical issues, gain information, advice and resources. 

If a person is in crisis we are able to refer to the appropriate service with consent, and if a person is feeling isolated and would benefit from regular contact, we will also offer this. 

If you or somebody you know would benefit from this service, either call us on 01724 844986, or complete the online form at https://www.surveymonkey.co.uk/r/serviceuserform

If the person consents, and would prefer to be contacted by us, please use any of the above methods to refer them into the service. If using the online form – please tick the box to state that you are referring as part of the ‘keeping people connected’ project. Do not worry if you do not have all the details needed to complete the form, our call handlers will do the rest.

Yorkshire Ambulance Service NHS Trust which is the provider of a number of services in the North Lincolnshire area, have released their latest briefing on how they are dealing with the Coronavirus pandemic, and how they are beginning to prepare for the next phase of the pandemic.

The chief executive of the trust has stated that;

“Our priorities continue to be to care for our patients deal with implications of the pandemic, work with our system partners to plan our response and to support and safeguard our staff.”

Below is a summary of how the trust is dealing with each of their service areas in response to the pandemic:

-          Emergency Ambulance Services – A&E Operations

Whilst staff have attended a significant number of patients with both suspected and confirmed COVID-19, the total number has remained lower than was originally anticipated by the trust.

The number of telephone calls to their emergency operations centre has seen a 25% reduction in April compared to March.

10% of all calls were dealt with through a new triage process which has been implemented nation-wide, and this has resulted in a reduction in ambulance attendances

More patients are also being treated on scene, or are being referred to another service for treatment.

-          Integrated Urgent Care – NHS 111

Calls to NHS 111 in April have reduced by approximately 41% compared to March, however they are still above a typical April with an increase of nearly 17% compared to 2019.

This pattern has been recorded across the country.

The trust have increased their capacity to deal with these issues by redeploying clinical staff, developing new COVID clinician roles, and bringing forward specialist training.

-          Patient Transport Service

Their patient transport service has continued to deliver around 1300 journeys per weekday in April, to ensure that the most vulnerable patients still have access to essential outpatient clinics.

The service is also being used to transport low acuity suspected and confirmed cases of COVID-19. 90 vehicles have been temporarily modified with barriers to keep both patients and staff safe. All staff are also wearing level 2 PPE.

As the UK now enters the second phase of response to COVID-19, the trust are working together with their partners to ensure that they can support the increase in outpatient services and the increase in non-COVID-19 urgent services.

They are also developing models to anticipate demand and to ensure their resources can meet the expected increase in demands.

On Sunday the 10th May 2020, Prime Minister Boris Johnson set out what he called a 'conditional plan' to reopen society, which included a few minor changes to previous guidelines. 

• People who can't work from home are now "actively encouraged" to return to workplaces, but use of public transport is being discouraged.
  
• People will also be allowed to take unlimited amounts of outdoor exercise, sit or sunbathe in parks and play sports with household members from Wednesday (13.05.2020)
  
• The changes in guidelines will also allow two people from different households to meet in a park if they stay at least 2m apart.
  

Mr Johnson said the government would 'modify' lockdown measures over three careful steps through to July.

Mr Johnson said he hoped the second step - "at the earliest by 1 June" would mean that some primary school children (those in reception, year 1 and year 6) may begin a phased return to school. It is also hoped that older children who are due to sit exams next summer may also have some time with their teachers before September.

The second step could also include the phased reopening of some non- essential shops, but only where social distancing can be maintained.

The third step could see some hospitality businesses and other public places reopen - "if the numbers support it" - but not earlier than 4th July.

All of this is subject to review at any time, and if infection rates begin to rise once more, strict measures could be reinforced.

Due to COVID-19, a number of changes have been made to dental services.

Routine treatments are no longer available, and patients may only be seen for some specific issues.

If you require urgent access to dental treatment, you should contact your usual dentist, or a practice in your area if you do not have a regular one you visit. All dental practices are responsible for triaging patients who contact the practice seeking access to urgent dental care (UDC). THis means patients that do not have a regular NHS dentist can still access urgent care.

Community dental services (CDS) are responsible for triaging patients with additional and complex health or social care needs, who contact the service seeking access to urgent dental care.

Anybody who contacts the dentists will go through a triage process and may be offered one or multiple of the following:

• Advice
• Analgesia (pain relief medication)
• Antimicrobials/antibiotics

The triage will also include a COVID-19 assessment of the patient, in line with national guidance to ensure their care can be managed accordingly.

There is no charge for the triage call, but any presriptions will be charged in the normal way. 

If people are referred for a face-to-face appointment, this will take place at what is known as an 'urgent dental care hub', which may be at another location. In remote or rural areas, this may require significant travel.

Locations have been chosen to cover the North East and Yorkshire region, however as drop-ins are not permitted, these locations are not being publicised.

Please remember that a face-to-face appointment will only be offered when treatment is extremely urgent, and staff members will be required to wear the appropriate PPE for the clinical procedures to be carried out. 

Face-to-face appointments will be charged at the normal rates, starting at £22.70 for band 1 treatment.

For further information, please contact the NHS England and NHS Improvement local dental teams at: england.yhdentalreturns@nhs.net

It has been reported that since the lockdown began, there has been a sharp increase in people seeking help and support for domestic violence.

Whilst generally, the lockdown means that you should not be leaving your home except for essential things such as food shopping and travelling to work (if you have to), the government states that:

"If you are controlled of physically, sexually, economically or emotionally abused by a partner, ex-partner or family member, this is domestic abuse and isolation rules do NOT apply." 

You may therefore leave your home to seek help.

All Boots pharmacies in the UK from 1.5.2020 now have safe spaces. Those needing help can ask staff at the counter to use the consultation room, where they will be able to contact services for help and advice. 

If you are a woman experiencing domestic abuse you may want to contact Refuge, the National Domestic Abuse Helpline, which is available 24 hours a day, 7 days a week on 0808 2000 247. Calls to this number are free.

If you are a man experiencing domestic abuse, you can call the Men's Life Advice service on 0808 8010 327, Monday and Wednesday 9am-8pm, or Tuesday, Thursday and Friday between 9am-5pm.

Please remember that you are not alone, and help is available. 

Coronavirus testing is available for millions of people from today, after the government loosened rules on who can apply.

Previously, testing was only available to key workers in Engand and their household member. 

Now, all care home staff, care home residents, people aged over 65, and those who must still leave their home in order to go to work are entitled to a test.

Tests are available at a number of pop-up drive-by locations across the country. Home-testing kits are also available in some areas, however they are currently limited. It is hoped that more of these will become available over time.

The government aims to hit its arget of 100,000 tests per day by Thursday, with just over 43,000 taking place as of Monday the 17th April. 

Anyone eligible can book a test on the government's test-booking website. 

Remember, if you think you have coronavirus, you should NOT visit your GP, hospital, or pharmacy.

Due to COVID-19, a number of changes have been made to the services available at the Virgin Care Sexual Health Hub (Ironstone Centre, Scunthorpe).

A summary of the service changes is as follows:

Appointments

All patients will now be provided with a telephone triage consultation. Only urgent or complex patient cases will be seen on  a face-to-face basis.

The number on which to contact the North Lincolnshire Virgin Care Sexual Health Hub is 0300 330 1122

You can access telephone triage to get help with:

• Emergency contraception
• Supply of contraceptive pills (for those wishing to begin this contraception or those wthing to continue with it)
• Complications arising from contraception e.g. significant coil pain, implant pain, signs of infection or serious side effects
• Options for patients who normally have contraceptive injections
• Advice and referral for abortion care
• Advice on treatment for any patient with symptoms of sexually transmitted infections (STI's)

Services which have stopped

• All routine provisions for LARC's (Long Acting Reversibe Contraceptions, including the fitting and removal of the IUD/IUS (coil), and implant. Patients will be offered alternatives such as the contraceptive pill and condoms.
• Cervical screening
• Vasectomies
• STI screening of patients with no symptoms

If your IUD/IUS (coil) or Implant is due for changing, don't worry. There is currently no evidence that leaving any of these in for longer than their licence is harmful. However, if you are worried about the risk of pregnancy, use additonal precautions such as condoms. You can also call the clinic if you require more advice on other options.

Emergency contraception

If you require emergency contraception, please choose one of the following options:

• Call the Virgin Care Sexual Health clinic on 0300 330 1122
• Contact your GP

Online services

A FREE Chlamydia, Gonorrhoea, HIV and Syphilis postal testing kit for people aged 16 and over is available to order online here.

If you are under 16, have symptoms or would like other STI tests, please call your local clinic.

PrEP

The clinic is currently unable to run routine PrEP appointments. 

With the current social distancing regulations, some people may choose to stop taking PrEP. For advice on stopping and starting PrEP visit https://www.iwantprepnow.co.uk/how-to-take-prep/

For those taking PrEP, a test every 3 months, alongside a HIV test is recommended (postal test availabel to order)

For people diagnosed with diabetes, this can be a particularly difficult time. 

In response to this, Diabetes UK have updated their webpages with coronavirus advice and information for people living with diabetes, and for their families. 

They also have some information to help people staying at home and managing diabetes, and to help people cope with stress and other emotions. There is also a useful coronavirus thread on thier online forum, where members are sharing tips and their experiences. 

Their dedicated Ramadan advice which is available on thier website also provides information on safe fasting and diabetes, including a factsheet on religious fasting. 

A brand new North of England Diabetes UK Facebook support group has also been started, which provides updates from key Health Care Professionals on local services and and important messages on care and support. 

The National Trading Standard Scams Team have recently released guidance on how to protect yourself from scams and fraud, and what to look out for.

This has come about as a number of new scams have been circulating, relating specifically to COVID-19 (Coronavirus).

Some of these scams include:

• People offering miracle cures or vaccines. There is currently NO specific treatment or preventatve vaccine for COVID-19.
• Home cleaning services
• People claiming to be healthcare workers and offering to deliver home testing kits
• Emails saying you can get refund son taxes, utilites and more
• A number of new mobile phone apps which claim to give COVID-19 updates, but instead lock your phone and demand a ransom
• People offering to do your shopping or collecting medication and asking for money upront and then disappearing

In order to help protect yourself from being scammed, there are a number of things you can do:

• Be cautious and listen to your instincs. Don't be afraid to hang up or close the door to people if you feel uncomfortable
• Take your time and don't be rushed by people
• If someone claims to be from a charity, as them for ID
• Be suspicious of services asking for money upfront, and try and check with a trusted relative or friend if you're unsure
• When online, be aware of fake news stories and adverts for miracle cures, home testing kits and vaccines. Do not order any of these.
• Protect your financial information such as bank details and PIN number. Never give your bank card or PIN number to a stranger. 

Please also note that banks, hospitals and the police will NEVER ask you for bank details over the phone. 

If you think you have been scammed, please report it to Action Fraud on 0300 123 2040, and if you need advice, please call the Citizens Advice Consumer Helpline on 0808 223 1133. 

Call your bank if you think you have been scammed.

If you are in immediate danger, call 999.

The Yorkshire Ambulance Service NHS Trust has released a statement explaining how they are coping with the current COVID-19 Crisis.

We have summarised the changes made to each of their three services below.

•  Emergency Ambulance Service - A&E Operations

With a 40% increase in calls, the service has adapted to this by increasing the number of patients who are either treated on-site or referred to another service. This will also help prevent patients unnecessarily travelling to hospital, and instead enable them to remain safe and at home.

• Integrated Urgent Care - NHS 111

During March, there was an 124% increase in calls requesting for NHS 111 services. To help cope with this increase, the trust has increased levels of staffing and redeployed clinical staff . They're also in the process of re-training 93 existing staff to join the integrated urgent care service to provide additional support during this time.

• Patient Transport Service

Whilst the trust is no longer taking patients to routine appointments and non-essential clinics, they are still working hard to ensure that the most vulnerable patients have access to essential outpatient services. In addition to this, they are also providing PPE for both staff and patients who are continuing to use the service, and are using the service to take a small number of suspected mild COVID-19 case patients to hospital, in order to free up emergency ambulance staff and resources. 

Here are some frequently asked questions and answers that have been provided by Public Health England on infection control of COVID-19 in care home settings.

Remember that if required, please seek advice from your local authority adult and social care team for operational, staffing, and mutual aid support as needed.

Q- Does the use of gloves, aprons and surgical masks protect service users or staff?

A- This PPE (Personal Protective Equipment) protects the health care worker who is working within 2 meters of the service user and it will also protect the service user in case the healthcare worker has been in contact with an infected patient. This in turn protects other service users and healthcare workers being infected.

Q- Is it important to hand-wash after removing PPE?

A- Absolutely! It ensures you are protected and do not pass the virus onto other vulnerable service users.

Q- If I have to perform chest compressions and defibrillation on a service user am I at risk of COVID-19?

A- In accordance with the guidelines your aprons, gloves and surgical mask will protect you when doing chest compressions and defibrillation only. When a paramedic arrives and if they intubate the service user they will wear higher protection and you will be asked to move away from the area whilst they carry out this procedure so you are protected.

Q-Can a care home take a resident back if they have tested negative for COVID-19 in hospital?

A- Yes. Follow the advice of the discharging ward. It would be advisable to care for the resident in their own room so they are self- isolating as they may have been exposed. Monitor the resident for symptoms.

Q- Can homes admit confirmed positive residents?

A- Yes, they will need to be isolated alone in their own room with en-suite and have dedicated staff, PPE, and follow national guidelines for 7 days following the showing of their first symptoms.

With the Easter weekend approaching, the Chief Executive of Northern Lincolnshire and Goole NHS Foundation Trust (NLaG) is urging people to stay at home.

By keeping themselves safe and staying at home, the public can help to reduce pressures that local healthcare services such as Scunthorpe Hospital, are facing.

The trust themselves have already implemented a number of strategies in order to prepare for a potential increase by:

·        Increasing capacity across its three hospitals (Scunthorpe General Hospital, Diana, Princess of Wales Hospital and Goole and District Hospital) by discharging patients who don’t need to be in hospital. They are also re-configuring wards so there are dedicated Covid-19 and non-Covid-19 areas, and are postponing non-urgent appointments and holding appointments via telephone or video consultation where possible.

·        Ensuring enough staff are available to work: staff testing began last week run by the Trust’s community services and Scunthorpe laboratory. Those staff at home self-isolating (and their families where relevant) are being prioritised so people can return to work. Some staff have cancelled their planned Easter leave, and retired and former health workers are returning to work

·        Redeploying staff: non clinical staff are being redeployed to support frontline areas and clinical staff who are currently in non–frontline roles are receiving refresher sessions to make sure they are ready to return to the frontline. Clinical staff across all areas are being trained in critical care to support highly specialist areas

·        Suspending visiting apart from in exceptional circumstances to reduce the risk to staff and patients

·        Launching a Care for Each other campaign to support the mental health and wellbeing of staff during this stressful time.

We would like to thank all members and staff working in the trust for their constant hard work and dedication.

North Lincolnshire Council is working with communities across the area to enable the delivery of food, essential medicine and social contact to vulnerable people who live alone and do not have family, friends or neighbours for assistance.

To make them aware of your circumstances or on behalf of someone else, please register using the form available here:

https://forms.office.com/Pages/ResponsePage.aspx?id=7VVmWP8siUCBl7TBC3s9...

If you cannot complete the form online, you can call the contact centre on 01724 297000 between 8am to 8pm, seven days a week and select option “0” for Covid-19 related support.

If you have a medical condition which makes you extremely vulnerable to coronavirus (COVID-19), you can register with central government for additional support.

You may have received a letter from the NHS telling you that you’re clinically extremely vulnerable, or been contacted by your GP or hospital clinician. If this has not happened, contact your GP or clinician after you register with this service.

It may take time for any support offered through this service to arrive. Wherever possible you should continue to rely on friends, family and wider support to help you meet your needs.

If you have received a letter, or someone you care for has, you can register for support by clicking the link below:

https://www.gov.uk/coronavirus-extremely-vulnerable

More people than ever before are offering up their time to help those in need, and that includes providing free services such as prescription collection and delivery to those who are vulnerable and self-isolating or shielding. Although it is preferred that a family member or friend collects medication on behalf of a patient, we recognise that this is not always possible, and in such cases, local volunteers become invaluable.

Whilst volunteering is a great way to help those in need and support the local community, there are also a number of things that volunteers must consider, and guidelines to follow which will ensure the safety of both the medication recipient and the volunteer themselves.

We have summarised these guidelines below, and request that anybody who is collecting and/or delivering prescriptions thoroughly reads them.

• Make sure you have the contact details of the person you are collecting medication for. This includes their full name, address, and date of birth. You will also need to be able to produce a form of valid ID for yourself.
• Ensure you have the contact details of the pharmacy from which you’re collecting the medication. If at any time you are unsure of what to do with a medication delivery, you should call the pharmacy team directly.
• To avoid potential confusion, the volunteer must complete all deliveries from a single pharmacy before picking up medications for delivery from another pharmacy.
• If the person must pay for an NHS prescription, the pharmacy will usually be able to do this over the phone, so ensure you have the patient’s phone number. If the pharmacy is unable to process the payment this way, then the volunteer should refer to their organisations guidelines on how payments should be made in these circumstances. Cash payments should be avoided where possible.
• Make sure you wear disposable or washable gloves when handling medication/medication bags.
• Try to transfer them in plain packaging where possible.
• Medicines deliveries must be completed the same day you collected them from the pharmacy, so make sure you have enough time to collect and deliver the medication.
• Some medicines may need to be stored in a fridge by the patient, so prioritise delivering these first.
• Any medicines that cannot be delivered must be returned to the pharmacy the same day.
• Do not open the bag of medicines the pharmacist gives you.
• If medicine packages are split, call the pharmacy and ask for further guidance.
• When arriving at the patient’s house, follow the guidance below:

-          Keep social distancing guidelines. Knock on their door then step 2m back. When the door is opened explain that you have come to deliver their prescription and ask them to confirm their name and address. DO NOT STATE THE INFORMATION TO THEM.

-          Once they have stated this, you may deposit the medication safely on their premises for them to collect.

• If the patient doesn’t answer, return he medication to the pharmacy. Do not post it through their letter box.
• Sometimes the pharmacy won’t have all the medication the patient requires. They will then issue an Owings Slip. It is important to give this to the patient and advise them that these items will be delivered when the pharmacy has the items back in stock.
• If the pharmacy has attached a message asking for the patient to contact them for further advice upon receiving their medication, ensure this message is delivered.
• If the patient has any questions regarding their medication, ask them to contact their pharmacy.

Updated 07.04.2020

Opening Times:

You can find the opening times of any pharmacy by visiting https://www.nhs.uk/service-search/find-a-pharmacy

Many pharmacies are currently closing for up to 2.5 additional hours a day (including lunch) in order to safely dispense medications and keep up with the increasing demand of prescriptions.

However, all pharmacies should at a minimum be open be open Mon-Sat 10am-12pm and 2pm-4pm. Most have their opening times displayed in their front window.

Delivery:

Some pharmacies offer a delivery service (which may incur an additional charge). Please contact your local pharmacy to see if they offer this sevice. 

Many are currently priortising delivering medication to those who are over 70 and/or vulnerable.

Volunteering - medication pick-up:

If there is a designated local provider offering volunteer services and medication collection, they MUST provide the following information to the pharmacy:

• Name of patient
• Address of patient
• Date of birth of patient

The volunteer must also provide photographic ID of themselves.

Primary healthcare professionals (GPs, pharmacists, nurses, social prescribers and local authorities) will all be able to request help for patients who are at-risk/shielding. Patients will be matched with a volunteer near them. 

Repeat Medication:

Patients have been advised to allow for 7 days from the date that the medication was ordered due to additional pressures on pharmacies. 

Repeat prescriptions can be made:

• Online - Visit your GP practice for more information
• Through the NHS App - Download the app and follow the instructions
• Electronic Repeat Dispensing (ERD) - Only if your GP has already offered you this service. Your prescriptions will download automatically at the pharmacy and you'll only need to contact your GP when the batch ends.

For patients without access to the internet, please post the repeat slip to the GP practice. Some have installed a dedicated box for this.

Urgent supply/emergency prescription:

If a patient is going to run out of medication and an urgent supply/emergency prescription is required, the patient should contact their prescriber immediately. A patient may be able to get medicine froma  pharmacist in an emergency, subject to conditions. If this is not part of an NHS service, there will be a charge.

Please note, that pharmacists who receive requests from a patient for an emergency supply or CPCS referrals from NHS 111 for urgent supplies, will use their professional judgement to determine whether an emergency supply is appropriate and legal to make. 

If it is not, the patient may need to be escalated up to the GP out of hours service or signposted to their own GP practice.

The government have set up a new, free to use service which aims to provide official, trustworthy and timely information and advice about Coronavirus (COVID-19), and will further reduce the burden on NHS services.

The GOV.UK Coronavirus Information Service is an automated 'chatbot' service which will allow the British public to get answers to the most common questions about coronavirus directly from the government.

The service will provide information on topics such as coronavirus preventionand symptoms, the latest number of cases in the UK, advice on staying at home, travel advice and myth busting.

The service will also allow the government to send messages to all opted-in users if required.

To use the free GOV.UK Coronavirus Information Service on WhatsApp, simply add 07860 064422 in your phone contacts then message the word 'hi' in a WhatsApp message to get started.

Below is some basic guidance on attending pharmacy, GP and hospital services. 

If you require more in-depth information or advice, please feel free to get in touch with us, or contact the relevant service directly.

Remember, if you are displaying any symptoms of COVID-19, you should NOT leave your home, and instead use the Government's guides on self isolation (Here)

If it is an emergency, please diall 999

Pharmacy:

Only visit your pharmacy if it's necessary and attempt to spend as little time there as possible.

Many pharmacies have introduced distancing measures (e.g. tape on the floor to ensure people keep their distance), however if there is nothing visible, please ensure to keep at least a 2 meter distance between yourself and the next person.

Some pharmacies also offer medication delivery -particularly for people in the vulnerable category for whom it is highly recommended to self-isolate. Please call your local pharmact for more information on this.

GP Practice:

Whilst you can leave your house for necessary medical appointments, many GPs have now stopped face-to-face appointments and are now only doing telephone appointments.

If you had anappointment booked, the practice will most likely contact you and inform you as to whether you should still attend.

Where possible, try to call your practice if you need to book an appointment, or use the online booking service which many practices now offer.

Hospital:

Scunthorpe General Hospital are reviewing all appointments and will let you know if we need to postpone yours. If you don’t hear from them, please attend your appointment as planned. They are trying to minimise face-to-face appointments where possible so you may be offered a telephone or video consultation instead

Visiting Scunthorpe Hospital is only currently allowed in exceptional circumstances: Visiting a patient at the end of their life, one parent visiting a child and birthing partners.

One birth partner can accompany for the labour and birth. Birth partners will then be asked to leave after spending some time together after the birth.

They are no longer allowing partners/family members in antenatal clinics, scans or any other appointments at the antenatal day unit.