Coronavirus: Practice Changes

On behalf of the doctors at Whiteladies Health Centre, we would like to give you some information to help you and your family in these challenging times caused by COVID 19, the disease arising from the Coronavirus.

We understand that this is a strange and scary time for everyone, and different from how life has ever been before. Your GP surgery is also going to seem strange and different.

We are not going to have the staff or the time to do lots of the things we normally do. Our main job will be to focus on the most unwell patients: to work out which of those need hospital and who we can help in the community.

practice changes

Many of them will have medical problems that have nothing to do with Covid 19, because these things won’t go away while we fight this crisis. All the usual serious problems like heart problems, depression, strokes and cancer won’t stop and we will need to keep treating these as well as Covid 19.

 

So how can you help us?

waiting room

Firstly, please do not come into the surgery. Even if it is tricky to get through on the phone (and we know it will be) please do not come in unless you have been specifically asked to by one of the staff at this time. This will help to protect you, us, and other vulnerable patients. We will explain more about this as we go along.

If you think you may have coronavirus, the current guidance is to look at 111online for advice  

There is currently not much we can do in general practice to help the symptoms of coronavirus beyond the options you already have: drinking enough water and getting enough rest. Paracetamol can help you feel a bit better but it won’t affect how quickly you recover from the illness or how poorly you get so don’t worry if you are having trouble getting hold of supplies.

If you feel you are becoming so unwell that you may need to go into hospital, the current advice is to call 111 (but this may change over time). In these circumstances, this is your best and quickest source of advice - please persevere if there are delays getting through.

If you think you need to phone the surgery, take a moment to have a think about why you are calling.

Think: can this problem wait and if so...how long? If it can wait until the end of the crisis, especially if you take some steps yourself to try to improve the symptoms, then don’t call us. Have a look on www.nhs.uk or https://111.nhs.uk/ , or www.patient.info to see if you can find out more about your problem: it might give you some self care tips you should try first.

Our website also contains useful self-care information

There is no point calling to ask for a referral for a routine outpatient clinic or operation as these are not happening at the hospitals until the crisis is over.

To keep you and us as safe as possible we are now telephone triaging all our appointments. Telephone triaging means speaking to you on the phone, to work out if your problem can be managed that way or if we need to see you face to face. The more things we can sort out over the phone, the lower our chances of catching Covid 19 from you, or you catching it from someone at the surgery or on your journey here.

We know it can feel strange not being able to see your doctor in person and not being examined. But did you know that 80% of diagnoses are made from the story of your symptoms alone?

Here are some tips for having a telephone triage consultation that can really help us:

  • Put your phone ringer on loud and pick it up when an unknown number rings. If we need to ring more than once it wastes valuable time. We will only try to call you twice.
  • Don’t be offended if we start by checking your name and other details before revealing who we are. This is to protect your confidentiality and prevent mistakes.
  • Ideally take some time to think about the symptoms you are calling about. Maybe write down notes. When did they start, what patterns have you spotted, what else is changing about your body?
  • Tell us what you are hoping for and what you are worried about. Don’t worry: this isn’t rude! If you have several things you want to talk about: tell us at the beginning. We may need to politely say that we can’t deal with all the issues but at least this means we can help you prioritise the important problems.
  • Tell us if you don’t understand something we’ve said or aren’t clear on the plan. It’s actually really helpful if you write down some notes as we go along and then repeat the plan back to us. Most people only remember 30% of what a doctor says: don’t worry - your memory isn’t failing you - that’s just normal!

At the end of most consultations we do something called safety netting. This is planning for what to do if things get worse and helps you know the “red flags” or warning signs to look out for. It might sound scary sometimes, because we often are describing the worst case scenario, not what we think is most likely to happen.

We can now send information via secure text messaging, and do some video consultations via your mobile phone. If we want to do a video consultation we will text you a link to click on to set up the consultation system. So far we have found the quality is not good enough to see fine details so please bear with us!

If we do ask you to come into the surgery we may ask you to wait in the car until we call you in, or even see you in your car. We will try to make this plan clear when we speak on the phone. If you are called in to the building, please use the hand sanitiser when you enter and leave.

Some things we do face to face at the surgery are currently carrying on: for example, we are still giving children their vaccinations (especially as mumps and measles are also going round in the UK at the moment), we are still dressing ulcers and wounds, and doing the blood tests that are too important to wait - including warfarin monitoring.

However, we are having to think tactically - like making a battle plan to focus on the most critical things.

So we are therefore deferring the following until after the crisis (even if you have already booked an appointment for this):

 

We are cancelling:

  • Travel advice and injections
  • NHS health checks and routine medication reviews
  • Minor surgery and injections, coil and implant fits
  • Spirometry
  • Routine monitoring blood tests that can safely wait

This is in line with what we have been advised by the government and what other surgeries will also be doing. However this may change. This list is up-to-date at the time of publication: we will try to post updates about this on our website.

You have already been a fantastic group of patients in the early stages of this crisis!

There are some more things you can do to help us in this fight.

  • Order your prescriptions online if possible, and expect them to take longer than usual. They will go electronically straight to the chemist, please allow 7 days before collecting from the pharmacy. Do not come to surgery to collect them. We cannot change the pharmacy that your prescription has been sent to. Please do not ask us to do this. Once issued by the surgery, your prescription must be collected from your “nominated” pharmacy, even if there is a queue there.
  • Please don’t over-order medications, especially like inhalers or paracetamol. If you don’t normally need an inhaler but fancy getting one just in case it helps if you get covid - don’t. Wait and see if you need it: if you do, you can call us and we can get an urgent prescription for you.The supply of inhalers is already running short - make sure those people who need an inhaler every day of their normal life can still get hold of them.
  • Please do still “bother us” if something feels important or worrying to you! For example, if you are worried your symptoms may fit with the red flags for cancer we want to hear from you. The 111 website can also be helpful to decide if you should call a GP about your problem.
  • If you need to call 111 or go into hospital, they may not have access to your GP medical notes, so they won’t know what medications you are on or your past problems. Think about writing these down somewhere, as well as any allergies that you have.
  • Have a think about what you want to do if you get very sick. Tell your relatives what you’d like to do, and consider writing this down somewhere it would be easy for paramedics to find (some people put this in the fridge, as paramedics always check in there for medications!). Get paperwork organised, and think about if anyone should have a spare key to your house.

Remember, your GPs, nurses, health care assistants, admin staff, receptionists, pharmacists and dispensers are all under stress at this time. They may be working longer hours while juggling worries about relatives, working in different ways from usual and knowing they have an increased risk of picking up Covid themselves. Everything we are used to is changing on a daily basis at the moment.

Please be patient with us, like you would with anyone else right now. 

Look after each other. Protect the vulnerable. Work as a community. Look after yourselves. Good food, good sleep, moving your body and finding the little things that still make you smile in all this craziness will help you stay fit and ready for whatever the next few months may hold.

Oh...and wash your hands! Properly! With best wishes

From the whole team at Whiteladies Health Centre