COVID-19: Practice Update

Posted by: Mark - Posted on:

Surgery Update 29 October 2020

We are OPEN, and very busy!

We are fully aware of the many stories in the national press about GP surgeries not being open. We also understand that we all want things to go back to how they were before the pandemic, and that  the initial support for the NHS, which was strong at the start of the pandemic, is wearing thin. Please know that we are doing the best that we can for our patients.

We cannot comment on what other surgeries are doing – but want to re-assure you that we are OPEN!

All GP appointment requests must still be first triaged over the phone, and if you cannot be safely managed over the phone or video consultation, we will arrange for a face to face appointment for you.

We launched our Phase 2 appointment book on 1 June 2020. We have subsequently moved to Phase 3, but still using an adjusted Phase 2 appointment book, to allow for the addition of previously halted services, such as ear syringing, joint injections ect.

Since 1 June 2020 to 29.10.2020 – the clinical team have completed:

Face to Face appointments4691 (this EXCLUDES the 2088 flu jabs given so far this year)
Telephone consultations5346
Video Consultations394
Virtual Care Home Ward Rounds88 – 4 x virtual ward rounds per week, covering 126 (approx.) of our care home resident patients. This equates to an additional 1500 telephone consultations
Home visits62
Urgent cancer referrals231 (for the same period last year, this was 238)
It is not possible to quantify some of our clinical team’s work – the daily tasks such as non -urgent referrals, reviewing test results, reviewing and actioning clinic letters, contacting patients with regards to results or clinic letters, managing and actioning our prescription requests, preparing reports for NHSE and WECCG, writing insurance reports, issuing sick notes, attending virtual Multidiscilinary Teams meetings – the list is endless, but we hope the numbers above will give you some reassurance that we are working hard, and doing the best we can for our patients.The numbers also does not reflect the work done by our Primary Care Support staff, such as our Social Prescriber, Integrated Mental Health Practitioner, Physio’s ect.It is also impossible to quantify to work done by our support staff, such as our reception and admin teams.We have taken on 467 new patients in this period, vs 320 de-registering, so our list size is still growing fast.

** above numbers are approximate and only reflects statistics from our appointment book on our clinical system. For example – it does not include consultations that are completed by a clinician after an assessment of a blood test result, or another kind of test result, or following the recipt of a hospital clinic letter which requires intervention. It only reflects work following on from a telephone call from a patient via the reception team. The true numbers will be higher, so the above is an indication of the level or work we are doing, not an exact figure.

PLEASE CONTACT US IF YOU NEED MEDICAL ATTENTION – remember that we may all sometimes think that an ailment or concern is not important, but please let a clinician decide. Call us, so we can assess you.

Cancer signs and symptoms

There is a legitimate concern that cancer diagnoses has fallen during the pandemic (Nationally) – we have worked hard to make sure we keep you informed over the last few months, but please follow the link below if you have any concerns. 

https://www.nhs.uk/conditions/cancer/symptoms/

Flu Campaign update

So far, we have vaccinated  2088 patients in “at risk” groups. Our Saturday clinics are now completed, and we are now doing flu vaccinations only within normal surgery hours. Please call the surgery to book an appointment if you fall into the at risk category, and wish to have a flu jab.

This year it is more important than ever to have a flu jab, due to the added complexities the COVID-19 pandemic brings. Research shows people can catch both diseases at the same time, with very serious consequences. Protecting yourself against flu does not just protect you, but other vulnerable people around you.

Vaccination is a choice – we understand that – but if you are at risk, and do not wish to have a flu vaccination, please let us know, so we can manage our flu vaccination stock effectively. If you have responded to our text campaign on 29.10.2020, you do not need to inform us again.

We have not had an update from NHSE about the new cohort – patients aged 50 – 64, not in an at risk group. We will inform you as soon as we hear anything.

Teaching

In addition to our workload mentioned above, we have restarted the teaching of Cambridge University Students, and Physician’s Associate students from Anglia Ruskin University. Many surgeries have paused this work due to the current pressures in Primary Care, but our Partners have decided that now is not the time to stop the development of future clinicians.

We wish to thank all our patients who consent to being part of our teaching programme – students learns as much from patients as they do from GPs and hospital consultants…if not more!

And lastly – thank you all for your support – it is very much appreciated!

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Flu Campaign 2020

Just a reminder that our Saturday flu clinics are currently just for patients aged over 18 who would normally qualify for an annual flu jab. We will be contacting the parents of those aged 18 and under to explain our plans for vaccinating this group.

We have been asked by NHS England to record Ethnic Origin for each patient aged over 18 who we vaccinate for flu. We will be asking patients when we vaccinate them, but you can decline to share the information.

To see which clinic and timeframe you have to attend and for clarification about how children are being vaccinated, please go to

http://www.thestanstedsurgery.nhs.uk/flu-2020,68189.htm

We ask that all patients attending our flu clinics wear a face covering. Please note that there will be no queueing inside the surgery – we will be managing on a one-in-one-out basis –so we apologise if the weather behaves badly…

Dr Andrei

Dr Andrei’s father is ill, and she needs to spend some time with him, and her family, in Romania. She has postponed this visit several times in light or travel corridors ect, but we are sure you understand the need for her to be with her father without further delay. She will be taking a few days annual leave shortly, but unless there is a change to current guidelines, she will need to work from home for two weeks after her return. She will be able to work effectively from home – the only thing she won’t be able to do, is see patient face-to-face in those two weeks. Thank you for your understanding.

We are OPEN

You will know that we have been doing our best since the COVID-19 outbreak to keep in touch with our patients, and remind you all that we are still here, but working differently. Although you still can’t book a face-to-face appointment with a GP, you will be contacted by a clinician via telephone, and if you cannot be safely managed over the phone or a video consultation, we will arrange for a face to face appointment.

We have restarted all previously paused services – HOWEVER – we still cannot do Minor Surgery or Joint Injections.

Please call us with any medical concerns, and our Reception Team will make the necessary arrangements for you.

Winter is coming….

We suspect this Winter will be very hard to manage this year, and we ask our patients to bear with us during this time.

Managing Winter demand this year be a major issue for us (one GP per day will be allocated to seeing only  “hot” potential COVID cases)  – leaving a reduced workforce to manage everyone else.

In addition, many of our staff are parents with school aged children, and bubbles closing at short notice at schools and nurseries affect us too. We have a very supportive team, and if and when gaps in the workforce arise, we do our best to fill in for each other. We are all in this together, and we ask for your continued support over the next few months – we promise to keep doing our best for patients.

Morelife Weight Management Service

MORELIFE ARE OFFERING FREE VIRTUAL & DIGITAL WEIGHT MANAGEMENT GROUPS ONLINE

 https://www.more-life.co.uk/what-we-do/our-services/in-your-area/essex/   MORELIFE IN WEST AND SOUTH ESSEX

PLEASE CHECK THE WEBSITE FOR MORE INFORMATION AND TO RESERVE YOUR PLACE

Surgery Statement 20 July 2020

We have not published a Surgery Statement for a few weeks. We were a little worried about information overload…which is something I think we can all relate to at the moment! The Surgery is still running smoothly, and we wish to update you with a few things.

Phase 2 appointment book

The phase 2 appointment book is working well, and is offering us the flexibility we need to look after our patients.

We want to thank you all for your continued support and understanding – we know that everyone is keen for things to be back to “normal” – including us – but the guidance states that we are to keep going with our current way of working for the foreseeable future.

Please remember – we are OPEN – call us if you have any medical issues, and we will ask a clinician to call you back. If you need to be seen face-to-face, this will be arranged for you.

The Surgery Team is working harder than ever – we’re just working in a different way. If you compare our current weekly workload with the same time period last year (based on database audits), we are actually having more contact with our patients on a weekly basis.

Remember that you can pre-book a telephone consultation with a GP or Advanced Nurse Practitioner via Patient Access.

Screening Programmes

All NHS screening programmes are up-and-running. If you are called for cervical screening, or contacted for Bowel Screening, or for any other screening programme, please take action. Do not delay!

Dr Berrocal

Due to a change in circumstances and following a risk assessment, Dr Berrocal is working from home for the foreseeable future. She can function fully from home – the only thing she cannot do is see patients face-to-face.

If she assesses a patient over the phone that requires face-to-face contact, she will arrange this with one of our other GPs working from the surgery premises.

Annual seasonal flu campaign

Yes – we need to get ready for this year’s flu campaign!

We will not be able to run our flu clinics as we have done in previous years. We are working hard in the background to get everything in place, and will inform you of our specific approach in August.

However – we have set the dates of our Saturday flu-clinics. These WILL NOT be ad-hoc walk-in clinics as in the past, as we will need additional time to change PPE after each patient encounter, and to manage the flow of patients in and out of the surgery to facilitate safe distancing. We anticipate a controlled invitation system, probably alphabetical – with arrival times spaced.

SAVE THE DATES!

Our flu clinics are planned for Saturday 26 September, Saturday 3 October and Saturday 17 October. To accommodate for the additional complexities, the clinics will run from 8am to 4pm (with a break for staff over lunch)

We are hoping for an increase in flu vaccination update this year, and have increased our vaccination orders in May 2020 to prepare for this.

You may have heard that there is an expansion in the National Seasonal Flu Vaccination Programme planned for this winter. We have not been informed what this will involve, but will inform you as soon as we are made aware.

Volunteer Group

Our fantastic group is still going strong. Many of our volunteers have gone back to work, but we are still able to support vulnerable patients. Please contact the surgery if you need any help.

Cambridge University Students

The Clinical School is sending us our 1st group of students in August. The teaching of medical students needs to continue, but this will look different to previous student placements. Students will continue to work under strict clinical supervision.

South Uttlesford Primary Care Network (PCN)

Our PCN continues to function well over the course of the pandemic, and we have now successfully grown it’s clinical workforce to include:

2 Pharmacists

1 Emergency Care Practitioner (Paramedic)

1 Social Prescriber

1 Physician’s Associate

We plan to further grow the PCN workforce with another Pharmacist and Physician’s Associate in the weeks to come.

These additional resources are shared between the Practices that make up our PCN (Stansted, Elsenham, John Tasker House, Angel Lane and Eden Surgeries) These new supporting clinical roles are instrumental in supporting our surgeries with our growing workload.

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Stansted Surgery Statement 4 June 2020

All vaccination programmes are still going ahead

Childhood Immunisations – all children due vaccinations must have still have them. This is important because disruption to immunisation programmes during a pandemic can result in an increase in vaccine preventable diseases – leaving children at huge risk.

Please contact the surgery to arrange an appointment if your child is due a vaccination. Please do not delay.

Pregnant ladies – pertussis vaccinations can be given to pregnant ladies from week 16 of pregnancy. Please contact the surgery to arrange for this important vaccination

***** we are not currently doing any travel vaccinations*****

Cervical Screening

The Cervical Screening Administration Service will restart cervical screening invitations and reminder letters on or around Saturday 6th June, initially for patients on early recall

We will also be pro-actively contacting ladies who are on the higher risk group for cervical screening.

If you get a call from us, or a letter from The Cervical Screening Administration Service, do not delay ladies – book your test!

Volunteer Week 1-7 June 2020

A HUGE thank you to our volunteer group who continue to support the surgery and all local residents throughout the pandemic – your contribution during this time is unmeasurable. Thank you so much!

COVID-19 Testing

Everyone can now have a test if they have symptoms. Testing should be within 3 days from the onset of symptoms. Please do not delay booking a test if you’re symptomatic, and until your test result is known, you, and your household MUST STAY HOME. For information on how to book a test, please follow this link:

https://www.nhs.uk/conditions/coronavirus-covid-19/testing-and-tracing/ask-for-a-test-to-check-if-you-have-coronavirus/

or phone 119

Information from PAH, St Margaret’s or Herts and Essex Hospital for patients requiring a blood test – but please note that you are welcome to attend the surgery for blood tests – please call reception to arrange.

“To comply with social distancing rules and of course keep patients and staff safe at this time, an appointment system is in operation at the outpatients’ departments at The Princess Alexandra Hospital, St Margaret’s Hospital, and Herts and Essex Hospital.

Open from Monday to Friday, 8.30am–4.30pm (excluding Bank Holidays).

Please request an appointment by emailing, or if no email available, call 01279 827163

To book an appointment please email paht.bloodtestappointments@nhs.net with the below information:

What is your surname?
What is your first name?
What is your date of birth?
Where would you like your appointment?Some blood tests are only available at Princess Alexandra. Your Doctor will advise you.Princess Alexandra, HarlowHerts & Essex Hospital, Bishop’s StortfordSt. Margaret’s Hospital, Epping
Is it a fasting test? (Yes/no/don’t know)
Is your appointment for a Glucose tolerance Test (GTT)?
What is your preferred day?
Would you prefer morning or afternoon?
Have you got your blood test request form? (if not we will print one for you)

You will be contacted within 1 – 2 working days with your appointment day and time.

If you have a mask please wear it.”

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Surgery Statement 28 May 2020

Our “New Normal” – NHS Phase 2

We will be launching our “new normal” appointment book from Monday 1 June 2020.

I apologise for the length of today’s statement – but please take a moment to note our new arrangements. We will be testing the new system for two weeks, and implement any changes thereafter if we identify any areas that are not working well.

Why the change?

We cannot go back to our appointment book from pre-pandemic, and we cannot sustain the appointment book we have been using through the pandemic on a long term basis.

We needed to rewrite our appointment book because:

  • We need to carefully monitor how many patients are in the surgery at any given time
  • We need to get back to a position where patients can pre-book contact with a clinician, including online via Patient Access – but this will be telephone consultation only. You are able to pre-book telephone appointments for a future date from today, either on-line, or over the phone.
  • We need to have a safe time every morning and afternoon to review patients who are symptomatic of COVID-19
  • Due to the additional time burden of the heightened levels of Infection Control required due to the pandemic, clinicians need more time during their daily face-to-face patient time to safely adhere to the strict measures in place to protect themselves, our staff, and our patients. Rooms and equipment need to be cleaned after each patient, and Personal Protective Equipment changed. To do this correctly takes time.
  • We need to make room during the working day for clinicians to have dedicated time to engage with our patients with long term chronic medical conditions. This will mostly be done remotely, and will be to review patients with conditions such as Asthma, COPD, Heart Failure, Coronary Heart Disease, Cancer, Hypertension, Diabetes, Mental Health, Stroke ect. The clinical team will be working on this huge task collaboratively, and we will write to or call these patients in the weeks to come to inform them of how and when their review will be taking place.

What has not changed?

You still cannot book face to face appointments via our Reception Team with a GP or Advanced Nurse Practitioner. The default position for all of these appointments is still via telephone (or video). Anyone who is accessed by a clinician over the phone and needs to be seen face-to-face, will be given an appointment date and time to attend the surgery.

What about the Nursing Team?

The Nursing Team will be seeing the most patients face-to-face, so we can restart important screening programmes, such as cervical screening. As most of our chronic disease monitoring will be done remotely by the wider clinical team, it is important that we now ask more patients to attend for blood tests, so they can be reviewed remotely with as much clinical information as possible. The Nursing Team will lead on this important function. Again – we need to make room for the increased infection control required, so appointment times have changed.

Please note that our initial efforts with regards to cervical screening will be focussed on those ladies who fall in the higher risk group – those who are on a yearly recall, as they have had abnormal smears in the past. Please don’t postpone if you are unsure – call us, and we will ask a nurse to assess your case.

You will be able to book your own face-to-face appointment with the Nursing Team by ringing the Reception Team. Please note that because of longer appointment times, the increase in blood tests required, and the time we need to allocate to the Nursing Team to manage long term conditions, you may have to wait longer than usual for a nursing appointment.

We will endeavour to make sure we make room for urgent matters, and if you are struggling to get an appointment for an urgent matter, please contact a member of the surgery Management Team, who will ask a clinician to assess the timeframe required for the appointment. We will always make room for urgent matters.

Patients who prefer to attend Herts and Essex Hospital for blood tests MUST book an appointment before they attend please – 01279 827163 (Mon-Fri 08:30am to 2:30pm)

Which services are still not happening?

Minor Surgery – but we are keeping a list of patients who need a Minor Operation, and will be in touch as soon as it’s safe. Note – Dr Leeman is still able to do joint injections, and to fit or remove the Contraception Coil

Travel Vaccinations

Spirometry (aerosol generating procedure)

Ear syringing (aerosol generating procedure)

Health Checks for those aged over 40 with no chronic medical condition

Private Medicals (but this is slightly depending of what’s required within the paperwork). Get in touch if you have a requirement, and we will be assess these on a case-by-case basis.

Face to face smoking support – but you are welcome to call for a telephone appointment with a member of the Nursing Team if you require support, or a prescription.

Attending the Surgery

All clinical staff, regardless of the nature of your appointment, will be wearing the required Personal Protective Equipment (PPE).

If you are attending the surgery, please wear a face mask if you have one, or a face covering – which can be anything from a scarf to a T-shirt… as long as it is clean! We know young children find this difficult – so we do not expect them to wear one.

Only invited patients may attend the surgery premises.

The front door is still closed, and all visitors must ring the buzzer to speak to a team member to obtain access to the surgery. This is because we need to be very careful of the amount of patients in our surgery at any given time, and because we will not allow access to anyone while we are assessing patients with COVID-19 symptoms.

Please note that COVID-19 symptomatic patients are assessed in a “hot” room – away from the rest of the surgery, and we have very strict infection control protocols in place. Your safety is at the forefront of our new appointment book.

Please do not enter the surgery if you have any COVID-19 symptoms – we really do need to stay alert.

The health of our entire staff and that of patients visiting the surgery is at stake. We need to work together to keep our service running safely.

Please do not arrive early for your appointment – this will affect the number of patients in our waiting room – and please leave as soon as your appointment is finished. If you need to make follow up appointments, please telephone us from home instead of asking at the Reception desk.

When you arrive in the waiting room, please clean your hands with the alcohol gel provided, and take a seat.

As always – if you have any enquiries – please email us on stansted.surgery@nhs.net or call us

And finally – a quick reminder

The main symptoms of coronavirus are:

a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)

a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

a loss or change to your sense of smell or taste – this means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal

To protect others, do not go to places like a GP surgery, pharmacy or hospital if you have any of these symptoms. Stay at home.

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Surgery Statement 20 May 2020

Some important information to note please:

Bank Holiday 25 May 2020

We will be SHUT this Monday – please call 111 with all medical enquiries on this day.

SCAM texts

We have been advised by Public Health England of reports today of a possible scam. Some women are being contacted by text message, with the sender claiming to be from the call and recall service to advise they are overdue for screening. The message asks them to call a mobile number and provide personal details.

Please call the Surgery Management Team if you receive suspicious health related communications

COVID-19 – Updated Case Definition

From 18 May 2020 the general clinical case definition for COVID-19 has been updated to include loss of or change in smell or taste. It is now:

New continuous cough OR fever OR loss of/ change in smell or taste

Everyone, including health and social care workers, should self-isolate if they develop a new continuous cough or fever or loss of/ change in smell or taste.

The individual’s household should also self-isolate for 14 days as per the current guidelines and the individual should stay at home for 7 days, or longer if they still have symptoms other than cough or loss of sense of smell or taste.

The “new normal”

We are currently working on defining what the “new normal” will look like for our Surgery. We are working hard on re-programming our appointment book, and making sure we structure it to work for both patients and our clinicians. We have to be ready for “new normal” by 12 June, and I will keep you informed of our new working model once we have completed this piece of work.

HERTS Urgent Care (HUC)

HUC is now back in our surgery on Tuesdays and Wednesdays – also only supporting via telephone triage. On those days, you may get a call from the HUC GP instead of one of our own GPs – this will free up some time for our clinicians to focus on supporting those of our patients with long term conditions.

Surgery Statement 6th May 2020

The ship is still sailing smoothly, with no members of staff in isolation.

Bank Holiday – VE Day – 8 May 2020

Please remember this day is a normal working day for the NHS and the surgery will be open as usual

Bank Holiday Pharmacy Opening Times:

These are the only pharmacy opening times we are currently aware of. We will publish a full list on our website and Facebook page when the information becomes available

Boots Stansted:             2pm-5pm

Williamsons:                 10am to 1pm and 2pm to 5pm

Stansted Pharmacy:      CLOSED   

Implementation of new Prescription Process

Whilst Stansted Surgery has always sent most of our prescriptions electronically to a patient’s nominated pharmacy, we are implementing EPS4 as recommended by NHS England. We will go live next week.

What does this mean for patients?

Most printed prescriptions will cease to exist. There are a handful of prescribed items that cannot be signed and sent electronically, but from next week, the default position is that all prescriptions will be sent to a pharmacy of choice electronically.

If you are unable to nominate a pharmacy, you will be given a printed token with a unique barcode, which will enable any pharmacy to obtain your prescription securely from the NHS Spine. 

We strongly recommend that all patients on regular repeat medication nominate a pharmacy to handle their prescribed medication. 

Your nomination can be changed at any time by contacting the surgery. 

All nearby surgeries who have changed over to EPS4 have reported very little change to business as usual.  To read more about EPS4 please follow this link:

https://digital.nhs.uk/services/electronic-prescription-service/phase-4

Childhood Immunisations

We are aware that some of our neighbouring surgery’s patients have had a letter from NHS England Immunisations to advise that childhood immunisations are now offered elsewhere – i.e. not on your own surgery premises.

This is not correct, and if you receive such a letter, please disregard it – we are doing all childhood immunisations here at the surgery, and the guidance is that immunisations should not be postponed during this time. Please call the surgery if you have any enquiries.

VE Day Celebrations – 8th May 2020

The Parish Council is going ahead with their VE Day 75th Anniversary Celebrations but as a Live Lockdown Party!  Follow local resident James Deejay Goochy Goodge on the Facebook Page VE Day Friday 8th May at 2.30pm to entertain your own lockdown party.  For more information on the Parish Council’s plans, click here

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Surgery Statement 29 April 2020

The Surgery is still running smoothly, with one member of staff in isolation.

New Telephone System

We are now up and running with our new telephone system, and thankfully the switch has not been too painful. It will take us a while to get use to the new system, and to use the additional functionality it offers, but we are definitely in much more control of our telephone system now than we ever were.

Please note that calls to the surgery are recorded.

Bank Holiday – 8 May 2020 VE Day

The 8th of May will be a normal working day for the NHS, as we continue to support our colleagues at NHS111. Please contact the surgery as usual on that day with any medical enquiries. NHS111 is still the first contact patients should make if they suspect they have COVID-19 symptoms.

Use the NHS111 online service https://111.nhs.uk/covid-19/

Or call 111 if you do not have on-line access

We are OPEN!

We would like to reiterate our message to patients – we are OPEN.

We are concerned that patients may be trying to protect the NHS by not contacting us at this current time with perceived non-urgent medical concerns. While this is much appreciated, we must all remember that even with the current pandemic patients will still become unwell with other illnesses, or developing new symptoms that may be of concern to a clinician.

Please call as usual with any medical matters. A clinician will contact you by phone, and/or arrange a video consultation, and if you need face-to-face intervention, this will be arranged.

Surgery Statement 20 April 2020

All is going well at the surgery, and we have no staff off due to illness or self-isolation. We now have access to a Staff COVID-19 testing centre. 

It’s happening! Our new telephone system is coming this week…

Despite the current pandemic, we are going ahead with the installation of our new telephone system. The new system will offer us the flexibility we need to offer our patients the best possible service, and we need a more reliable system urgently.  

The planned date for going live is 23.4.2020. We anticipate a short downtime during the switchover between our old and new systems, but we will plan to do this over the lunchtime period, when our phones are off for a short while.

Please keep your fingers crossed for a smooth transition! We will keep you updated via our Facebook page if we run into any trouble.

Thank you!

Many thanks to all our patients for your support during these difficult times. Thank you to all our fantastic volunteers who are helping us support the community, and thank you to everyone who have supported the Friends of Stansted Surgery fundraising efforts. We are grateful to you all.

Surgery Statement 13 April 2020

We are still functioning very well, and currently have no staff members in isolation. We are mindful that the situation is changing on a daily basis, but we have prepared as best we can, and feel that we are ready whatever comes our way.

I am very grateful for the continued commitment from all our staff at the surgery. Their dedication and loyalty to our patients and surgery inspires me daily.

I am also grateful to our GP Partners – Drs Leeman, Henderson, Andrei and Bata – for their strong leadership at this time. Their professionalism continues to lead by example, and we are reminded daily how much our hard work is appreciated.

Remember – we’re still open!

We are concerned that patients may be trying to protect the NHS by not contacting us at this current time with perceived non-urgent medical concerns. While this is much appreciated, we must all remember that even with the current pandemic patients will still becoming unwell with other illnesses, or developing new symptoms that may be of concern to a clinician.

We are currently still able to cope with our workload, and we urge patients to call us as usual to discuss any medical concerns with a clinician. Interventions or tests may still be required, and we can do most of those over the phone, or by video consultation, and will still see you face-to-face in the surgery if needed.

It may be that in the near future we could become overwhelmed with COVID-19 work – but if that happens, we will let you know.

Our message today is – please telephone the surgery with all medical needs as if there is no pandemic happening. A clinician will call you back, and decide whether treatment now is needed, or if we can follow you up at a later date.

NHS 111

From Tuesday 14 April 2020, NHS 111 will have the ability to book telephone consultations directly into our Stansted Surgery appointment book. These will be for patients with COVID-19 symptoms that require follow up by their own GP Surgery. Stansted Surgery was one the test sites for this new service, and it works well. We will call those patients booked into our appointment book, and assess them over the phone, or via video consultation.

The Stansted Army

We are very grateful to our volunteers who are helping us to look after the most vulnerable people in our community. Many people are suffering financial hardship during the current pandemic, and although we have had very generous donations of non-perishable food, it will not be enough to keep our efforts going for the next few weeks.

Please note that the GoFundMe page has not been set up to raise funds for the surgery, but instead to enable our Surgery to keep supporting local people who have financially been hit by COVID-19, and need essential food supplies. The funds are not managed by the surgery, but by our volunteers. You do not need to a patient of Stansted Surgery to ask for help – please just call the surgery, and we will do our best to support you.

The funds raised so far will also pay for the 6000 leaflets that have been delivered to Stansted and surrounding areas, as well as the materials required by the volunteers sewing scrubs for our clinical team.

If finances are not an issue, but you need help with medication delivery, essential shopping, dog walking, or just a friendly chat on the phone when social isolation becomes too much, please contact us – we have a fabulous army of volunteers eager to help.

Any funds left unspent when we get through to the other side of this pandemic, will be handed over to our Patient Participation Group, who will decide how to allocate the resource. This decision will not involve the surgery in any way.

You can support their efforts here:

https://www.gofundme.com/f/friends-of-stansted-surgery-community-support?utm_source=customer&utm_medium=copy_link-tip&utm_campaign=p_cp share-sheet

Surgery Statement – 7 April 2020

Boots Stansted – under tremendous pressure

We need to work together to support the staff at Boots – they are currently under tremendous pressure for many different reasons, and none of those reasons within their control, which makes things even more frustrating for them.

Please don’t use today’s surgery statement as a starting point for criticism of the Boots team – it is not intended for that purpose. Instead, we ask the community to get behind them, so they can continue to look after their customers. 

As in many workplaces, Boots have staff who are ill or in self-isolation, leading to a reduced workforce.

In addition to this, NHS England has been pushing very hard since the current pandemic started for all GP Surgeries in England to move patients over to EPS – Electronic Prescribing Service

 This means that patient’s prescriptions are signed by GPs and sent to pharmacies electronically. This is a very good way of reducing footfall to surgeries, but the NHS Spine, that has to handle all of these “transactions”, is not coping very well with the increased traffic, so often electronic prescriptions does not reach the intended pharmacy for 24 (or more) hours. NHS Digital is working on expanding the Spine’s capacity, but for now, the situation is difficult and unpredictable. 

This factor, in addition to the tremendous pressure on the Pharmacy Supply Chain, is making their job very tricky, and making their usual turnaround time of 48 hours impossible to meet.

For patients using Boots to dispense their medicaction- please help them during this difficult period by:

–       Not ordering your prescription too early

–       Please do not order medication you don’t need, for “just in case”. This  is causing huge disruption in the supply chain

–       Please give at least 72 hours from ordering to collection

If you are using a surgery volunteer to collect your prescription from Boots for you, please note that we can now only collect from Boots once a day at 4pm, and that your prescription may not be delivered to you until the next day.

Please note that if you are asking a volunteer to buy behind-the-counter medication for you from a pharmacy (any pharmacy), that this is not necessarily a straightforward matter.

Pharmacy staff may have to ask clinical questions with regards to other medications that you are taking, what symptoms you have etc, and have to use their clinical judgement and expertise about the suitability of any behind-the-counter medication before they can sell it. You MUST provide a phone number to your volunteer if you are asking them to buy behind-the-counter medication, so the pharmacist can call you to discuss your proposed purchases, so clinical safety can be maintained. 

SURGERY STATEMENT 2 APRIL 2020

The surgery is continuing to function well, and currently we have no staff in isolation. We are mindful that there is going to be an increase in suspected and confirmed COVID-19 cases in the days and weeks to come, but we feel confident that we have planned well in advance to cope with whatever will come our way.

ADVICE TO PATIENTS REMAIN

–          STAY AT HOME

–          ESSENTIAL TRAVEL ONLY

–          WASH YOUR HANDS

THESE SIMPLE MEASURES WILL HELP TREMENDOUSLY TO KEEP EVERYONE SAFE– PLEASE ACT RESPONSIBLY

EASTER 2020

The Surgery will be open as usual over Easter – Friday 10 April 2020 and Monday 13 April 2020 will be normal working days for us. We will be on duty from 8am to 6:30pm. Please do not contact NHS111 for non COVID-19 matters on these days.

PREPARING AHEAD

All surgery administrative staff and the entire nursing team have been trained to use the surgery phone system, to ensure we always have plenty of cover in the weeks to come. Our phones are our main point of contact for patients at the moment, and we have done all we can to protect this crucial surgery function.

Patients who are invited to attend the surgery will notice some further changes inside the surgery. This has been implemented to protect our patients and staff. We will have designated areas for suspected or confirmed COVID-19 patients, and separate areas for non COVID-19 patients. Please listen carefully to the instructions given to you by our team before coming to the surgery. You will be signposted by staff members when you arrive.

What should I do if I develop COVID-19 Symptoms?

Do not leave your home if you have coronavirus symptoms

Do not leave your home if you have either:

  • a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

To protect others, do not go to places like a GP surgery, pharmacy or hospital. Stay at home.

Use the 111 online coronavirus service to find out what to do.

IN THE FIRST INSTANCE 

 Use the 111 coronavirus service – https://111.nhs.uk/covid-1

Only call NHS111 if you cannot get help online

HELP US TO HELP YOU

WE URGE PATIENTS TO HAVE AT LEAST ONE MEMBER IN EACH HOUSEHOLD TO CREATE A DOCTORLINK ACCOUNT, SO WE CAN CONSULT WITH YOU VIA VIDEO.

IT IS IMPORTANT THAT WE CONTINUE TO REDUCE FOOTFALL TO THE SURGERY – AND VIDEO CONSULTATION IS INSTRUMENTAL TO ACHIEVING THIS.

To use Doctorlink, you will first need to register online either via this website or by downloading the app on your mobile device via Google Play or the App Store.

We are still waiting for final guidance, but we suspect NHS111 will divert some COVID-19 patients to GP Surgeries during the triage process. These will all initially be telephone consultations by our clinical team. In the days/weeks to come, NHS111 will be able to book telephone triage appointments straight into our surgery appointment book.

ADDITIONAL HANDS-ON SUPPORT FOR THE SURGERY

Please note that in the weeks to come, we will be supported by staff members of the South Uttlesford Primary Care Network, and West Essex Clinical Commissioning Group. In particular, we will be supported by Pharmacists and Emergency Care Practitioners. Please treat them as part of our team – they are working on our behalf to support our patients.

What should I do if I need help with prescriptions, food shopping, a friendly chat on the phone, or other essential tasks?

The Surgery has amassed a small army of volunteers supporting us in getting help to patients who need it. They are working tirelessly behind the scenes, and we are very grateful for their support. We also have some non-perishable food donations to assist patients in need.

If you need help, please contact the surgery.

The volunteers are also currently working on a leaflet to distribute to Stansted and the surrounding areas.

We will keep you informed if arrangements on how to access help changes, but for now, please contact the surgery.

Uttlesford District Council is also running a scheme for those who require help:

Ph. 03333 408 218 or communityresponse@uttlesford.gov.uk

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Stansted Surgery Update – 25.3.2020

Continuing to look after our patients

In line with guidance from NHS England and Public Health England, our front door is now shut. Patients who have been asked to come to the surgery, must ring the bell to speak to a receptionist in order to gain access. Everyone else must please call the surgery first. All routine face-to-face appointments are being cancelled, and we will do whatever we can over the phone. The Reception Team will be in touch with you if you have an appointment booked with us currently.

We have very specific guidance about which patients we must continue to see face-to-face, and we are very appreciative of all your support – we know the inconvenience this is causing, but we must work together to secure the best possible outcome for patients and staff.

To reduce the footfall in the surgery as much as possible – our GPs can now offer video consultations – at the moment these are booked at GP request only. You will be telephoned first, and if the clinician determines that a video consultation might negate the need for a face to face appointment, this will be booked for you by the clinician. YOU MUST HAVE AN ACTIVE  DOCTOTORLINK ACCOUNT ON YOUR SMARTPHONE OR DESKTOP/LAPTOP  CAMERA.

We will be setting up our Nursing Team with a web cam in the days to come, so they too can connect with patients in this way when required.

We have already done some video consultations over the last couple of days, and it works very well.

Adults can register themselves on Doctorlink if the video consultation is for a child.

To use Doctorlink, you will first need to register online either via this website or by downloading the app on your mobile device via Google Play or the App Store. Registration is simple and takes around 2-3 minutes

When it comes to near the time of your video consultation appointment, please go to your Doctorlink account and “check in” for your appointment, and stay with your phone/computer. The Doctor will join the consultation from his desktop or laptop as close to the allocated appointment time as possible.

Supporting our NHS Colleagues

Our friends at Elsenham Surgery are currently severely affected by the developing COVID-19 situation, and we have stepped in to support them, just as they will when we will need them in the weeks to come.

We will be seeing any patients from Elsenham Surgery who requires a face-to-face appointment on our premises whenever needed, and certainly until Elsenham’s clinical team become fully fit to work safely. On some days, we may need to deploy some of our GPs to Elsenham Surgery to support the staff there, but we will be able to continue looking after our own patients too.

Sick notes for employers

If you require a sick note for work because you have been instructed to self-isolate, please go to https://111.nhs.uk/isolation-note for the required evidence you need. Alternatively, you can download our surgery form here.

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Surgery Update 19.3.2020

Including: Keeping safe, the continuation of the childhood immunisations programme, and how to ask for help

Keeping Safe

The Surgery is functioning very well during this pandemic, even with two GPs in isolation. They are able to work very effectively from home.

We are very grateful to our patients who are adhering to the guidance to not come into the surgery unless they absolutely have to – it really helps us focus on protecting the most vulnerable, and keep our staff safe.

Keep washing your hands, and follow the rules of Social Distancing! 

https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults

The Surgery staff will also be affected by the imminent closure of schools, but the loyalty and professionalism of our team will mean that we will be able to keep our service running. We are bursting with pride at the moment – we truly have a fantastic team.

Guidance for the Childhood Immunisations Programme during COVID-19

The guidelines from NHS England are that we should continue to immunise children during this time. If your children are due routine childhood immunisations, please book the required appointments, but please do not attend if the family is in self-isolation at the time, or have any cold or flu symptoms.

Please telephone to the surgery to speak to our Nursing Team if you require any information, or reassurance. The specific communication from NHS England with regards to Childhood immunisation:

“Dear GP Practices,

Given the risk of the serious infections that the vaccines protect against, PHE are currently recommending that the routine primary immunisation schedule should not be delayed.

We are aware of some reports of parents facing difficulty in obtaining paracetamol; whilst parents should continue to try to obtain and administer infant paracetamol if possible; infant vaccines can and should still be given even if it is not possible to give prophylactic paracetamol.

Parents who have been unable to obtain infant paracetamol should be advised as follows:

– Fever can be expected after any vaccination but is more common  when  the MenB vaccine (Bexsero) is given with the other routine vaccines at  eight and sixteen weeks.

–       In infants who do develop a fever after vaccination, the fever tends to  peak around six hours after vaccination and is nearly always gone  completely within two days.

–       Ibuprofen can be used to treat a fever and other post-vaccination  reactions. Prophylactic ibuprofen at the time of vaccination is not  effective.

Information about treating a fever in children is available from the NHS UK webpage “Fever in children” at www.nhs.uk/conditions/fever-in-children/

–       If an infant still has a fever 48 hours after vaccination or if parents are  concerned about their infant’s health at any time, they should seek  advice from their GP or NHS 111.

The diseases that the vaccines protect against are very serious and therefore vaccination should not be delayed because of concerns about post-vaccination fever. We have also been made aware of concerns that parents will not know whether a fever in their infant following immunisation is due to their immunisations or to COVID-19.

Indications to date suggest that COVID-19 causes mild disease in infants and children. As has always been recommended, any infant with fever after vaccination should be monitored and if parents are concerned about their infant’s health at any time, they should seek advice from their GP or NHS 111.

The same advice applies to teenagers who are due their routine adolescent immunisations. Teenagers are less likely to develop vaccine reactions such as fever and if they do, these are generally short lived and resolve quickly.  COVID-19 is associated with a more prolonged course of illness with respiratory symptoms, especially cough, which would not be expected following vaccination. As with the infant primary immunisations, PHE are recommending that the routine adolescent immunisations should not be delayed.”

Individuals or families that need help

Any patients in need of assistance from our voluntary group must please contact the surgery. Our Reception Team will complete a referral form, and we will then hand the request for assistance over to our volunteer group. We have already had some referrals, and the volunteer group has been absolutely fantastic in stepping in to help.

Our Surgery Boardroom is now a storeroom for supplies that have been donated to help us keep vulnerable patients stocked up with essentials. This fantastic effort is being led by one of our volunteers, Kirsty Pope.  The fantastic children at St Mary’s Primary School are doing a collection for us tomorrow, which is a very thoughtful way of ending their adjusted school term.  If anyone wants to make donations, they can do so at Mountfitchet Romeera Reception, or at the surgery – but please only come in if you are well!

If you require some emergency supplies, please do not hesitate to contact the surgery. Now is not the time to feel ashamed – we all want to help each other. Let’s face it; getting our hands on the most basic supplies can be a huge issue at the moment!  Please look out for the elderly and vulnerable families, and ask them to get in touch with the surgery if they need supplies.

STANSTED SURGERY STATEMENT 17 MARCH 2020

Extraordinary times will need extraordinary mutual effort by our community and surgery

TO SUPPORT OUR SURGERY TO KEEP OUR SERVICE RUNNING WE NEED OUR PATIENTS TO:

PLEASE DO NOT ENTER OUR PREMISES UNLESS YOU HAVE BEEN INVITED TO DO SO.

WE CURRENTLY HAVE 2 GPs SELF ISOLATING BUT THEY ARE ABLE TO TELEPHONE TRIAGE FROM HOME.

THEY WILL BE CONTACTING PATIENTS FROM THEIR PRIVATE MOBILE OR HOME NUMBERS AND WE RESPECTFULLY REQUEST THAT PATIENTS DO NOT CONTACT THE GPs DIRECTLY – ALL CALLS MUST COME VIA THE SURGERY.

ANY VIOLATIONS OF THIS RULE WILL LEAD TO A REMOVAL FROM OUR PATIENT LIST WITHOUT DISCUSSION.

WE ARE DEALING WITH A PANDEMIC AND WE NEED PATIENTS TO HELP US FOCUS ON IMPORTANT MATTERS.

PLEASE CALL US WHEN YOU NEED A SERVICE – DO NOT COME INTO THE SURGERY TO MAKE APPOINTMENTS, ORDER PRESCRIPTIONS, REQUEST SICK CERFIFICATES ETC

01279 813200   01279 818057      01279 818053

YOU CAN ALSO EMAIL US ON stansted.surgery@nhs.net

FOR THE FORESEEABLE FUTURE WE WILL ALLOW PATIENTS TO ORDER MEDICATION OVER THE PHONE – 01279 818051

PLEASE ONLY GET IN TOUCH IF YOU ABSOLUTELY NEED TO.  WE NEED PATIENTS TO BE RESPONISIBLE AND SELF-CARE AS MUCH AS POSSIBLE. THIS WILL ENABLE US TO FOCUS ON OUR MOST VULNERABLE PATIENTS, WHO WILL SUFFER MOST DURING THIS PANDEMIC

ALERT 

LASTEST GUIDANCE FROM PUBLIC HEALTH ENGLAND – PLEASE NOTE THE CONTENT TO KEEP YOURSELF INFORMED.

https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults

OUR VOLUNTEER GROUP IS UP AND RUNNING – IF YOU NEED ANY HELP PLEASE CALL OUR RECEPTION TEAM. WE CAN HELP WITH PRESCRIPTION COLLECTION AND DELIVERY, DOG WALKING, ESSENTIAL SHOPPING OR JUST A FRIENDLY CHAT ON THE PHONE IF YOU ARE FEELING VERY ISOLATED.

ALL VOLUNTEERS ARE SIGNING SURGERY CONFIDENTIALITY AGREEMENTS FOR YOUR SAFETY

SURGERY STATEMENT 14 MARCH 2020

Additional changes to our appointment system, to protect patients and our staff

From 16 March 2020, we are cancelling all routine face-to-face GP appointments. Instead, we will be offering an enhanced telephone service. All requests for appointments must be made by phone, and will be triaged by a clinician over the phone. If you need to be seen face-to-face, this will be arranged for you.

To help with this additional pressure on our telephone system (pending the new system being installed), we are giving out today two additional phone numbers patients can call, but only between 8am and 11am

01279 818057

01279 818053

The main surgery number will still be staffed by two receptionists – 01279 813200

Video consultations will be launched this coming week, to provide patients with another option to connect with their GP.

Please note that video consultations will only be available to patients who have an account on Doctorlink. To use Doctorlink, you will first need to register online either via this website or by downloading the app on your mobile device via Google Play or the App Store.

Doctorlink is only available to patients over the age of 16, but we will be able to book video appointments for children in their parents’s names. 

What about pre-booked appointments?

You can still attend these, unless you have cold and flu symptoms. You may choose not to attend the surgery at this time. Please inform our Reception Team, who will ask the clinician to phone you instead. You will be called at the time of your pre-booked appointment (approx.).

From 16 March 2020, patients will no longer be able to attend the surgery premises at 8am to try and secure an appointment for that day. All appointment requests must be made by phone.

What about new follow up requests?

We will attempt to do most follow ups over the phone. If a clinician asks you to make a follow up appointment, please book this via Reception as usual, informing them that it is a telephone appointment. Clearly, not all follow ups can be done over the phone, and if your clinician wants to review you face-to-face, they will inform you – so you can inform the Reception Team.

What happens if the GP Surgery staff becomes ill?

We are implementing the above changes to keep our staff safe. However, it would be naïve to suggest that our staff will not be affected by the COVID-19 outbreak. All 5 of our GPs, and our Practice Manager, have NHS laptops with secure access to our NHS servers. If needs be, we can work securely from home to keep our service running.

From Monday 16 March 2020, all surgery staff, and other professionals using our premises, will perform and record a temperature check before embarking on their working day. This will happen under the supervision of our Infection Control Lead, Nurse Jane Buckingham.

We thank all our patients for their support and understanding during these extraordinary times.

A call for Surgery Volunteers:

We are aware that Uttlesford District Council is working on a support system to help those most vulnerable during the months to come. However, we wish to be proactive in setting up something informal now. Once UDC has a robust support system up-and-running, we will step back if needed.

There are many vulnerable patients who are going to need help with shopping, getting their medication, dog-walking etc. in the weeks to come.

We have written to our most vulnerable patients yesterday to offer some reassurance that they will be looked after. The Surgery Team will do whatever we can to help patients, but we may need some additional helpers. 

We know that the people of Stansted are very civic minded, and will be happy to support us. Please be aware that our catchment area is not small… and some patients live in particularly rural areas. It’s a big ask, and any help will be much appreciated.

If you are interested in supporting the surgery in the months to come with helping some of our most vulnerable patients, please email the surgery at stansted.surgery@nhs.net. Please include your contact details – phone number and address, as we cannot access patient’s medical records to extract your contact details for this purpose.  I suspect that the most effective and reactive  way to use our volunteers will be by forming a Whatsapp group. Please confirm in your email if you consent to this approach.

Thank you

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Stansted Surgery Statement 12 March 2020

We understand that the impact the current COVID-19 outbreak is causing anxiety and worry for patients.

We need to work together to protect the community and our staff. Patients are still attending the surgery with cold and flu-like symptoms, and this is not acceptable at this time. It puts the health of vulnerable people at risk, and the health of our Surgery Team, who has to support the 11000 patients we care for.

Sadly, our Reception Team is experiencing conflict from patients who are unhappy with the current guidelines.

Please be kind to our team – we are here to help – but we have to follow  the protocols directed to us by NHSE and Public Health England. 

The GP Partners will not tolerate abuse to staff members, and each case will be followed up by Management. These are extraordinary times, and we will continue to do out best for our patients, but battling this outbreak will need involve mutual effort.

PLEASE DO NOT ATTEND OUR SURGERY IF YOU HAVE ANY COLD/FLU-LIKE SYMPTOMS, SHORTNESS OF BREATH, COUGH ECT, REGARDLESS OF YOUR TRAVEL HISTORY – EVEN WHEN YOU ARE NOT THE PATEINT, BUT JUST ACCOMPANYING SOMEONE ELSE.

IF YOU HAVE COLD OR FLU SYMPTOMS, PLEASE FOLLOW THE GUIDANCE THAT WE HAVE TO WORK UNDER IN THE CURRENT CIRCUMSTANCES, AND CALL NHS 111 OR GO TO HTTPS://111.NHS.UK/COVID-19

Thank you.

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FOR INFORMATION ABOUT SELF-ISOLATION, PLEASE CLICK ON THE LINK BELOW

https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-people-with-confirmed-or-possible-coronavirus-covid-19-infection

Thank you

CORONAVIRUS INFORMATION

PLEASE NOTE THAT THE ON-LINE BOOKING OF APPOINTMENTS HAS BEEN SUSPENDED FOR THE TIME BEING.

Surgery Statement – 9 March 2020

The Stansted Surgery Partners have today implemented a new policy to help us protect our patients and staff:

Effective immediately – ALL patients, regardless of travel history – with cold and flu like symptoms, incl all respiratory symptoms – cough, ear pain, shortness of breath, a temperature etc, MUST go online and complete the risk assessment on the NHS111 website. The advice given by NHS 111 must be followed, and you will be required to provide evidence that you have completed the risk assessment if you have been signposted to the surgery by NHS 111.

For the NHS 111 on-line assessment – please follow this link

https://111.nhs.uk/covid-19

PLEASE DO NOT ATTEND THE SURGERY UNLESS YOU HAVE COMPLETED THE SCREENING PROCESS.

Please expect additional questioning by our Reception Team when getting in touch with the surgery – we will not be able to book any appointments unless we get the required information from patients.

We appreciate your support in helping us keep the community safe.

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COVID-19

Important information about the coronavirus (COVID-19) The NHS and Public Health England (PHE) are well prepared for outbreaks of new infectious diseases. The NHS has put in place measures to ensure the safety of all patients and NHS staff while also ensuring services are available to the public as normal.
The latest information on symptoms of coronavirus infection and areas where recent travel may have resulted in a high risk of exposure can be found on nhs.uk/conditions/coronaviruscovid-19/

NHS 111 has an online coronavirus service that can tell you if you need medical help and advise you what to do.
Use this service if:
• you think you might have coronavirus;

• in the last 14 days you’ve been to a country or area with a high risk of coronavirus;

• you’ve been in close contact with someone with coronavirus.

Do not go to a GP surgery, pharmacy or hospital. Call 111 if you need to speak to someone.

Like the common cold, coronavirus infection usually occurs through close contact with a person with novel coronavirus via cough and sneezes or hand contact. A person can also catch the virus by touching contaminated surfaces if they do not wash their hands.

Testing of suspected coronavirus cases is carried out in line with strict guidelines. This means that suspected cases are kept in isolation, away from public areas of GP surgeries, pharmacies and hospitals and returned home also in isolation. Any equipment that come into contact with suspected cases are thoroughly cleaned as appropriate. Specific guidance has also been shared with NHS staff to help safeguard them and others. Patients can be reassured that their safety is a top priority, and are encouraged to attend all appointments as usual.

Everyone is being reminded to follow Public Health England advice to:

• Always carry tissues with you and use them to catch your cough or sneeze. Then bin the tissue, and wash your hands, or use a sanitiser gel.

• Wash your hands often with soap and water, especially after using public transport. Use a sanitiser gel if soap and water are not available.

• Avoid touching your eyes, nose and mouth with unwashed hands.

• Avoid close contact with people who are unwell.