In response to phone calls we have been getting and advice, we have produced the guide below to hopefully help explain what you should and should not be doing. Unfortunately, the volume of information available can make things quite confusing. We would welcome any feedback on the answers below and if things are still not as clear as they should be.
There are three key terms that you will hear and need to be familiar with. These represent the things that people should currently be doing to protect themselves and others:
What is social distancing?
Social distancing means reducing social interaction which in turn will reduce the spread of Coronavirus. This means:
- Maintain 2m distance between you and other people and try to maintain this with members of your household. 2m is the same as 6 feet or about 3 steps
- Avoid contact with anyone with symptoms of Coronavirus (continuous cough and/or fever).
- Avoid using public transport unless it is essential.
- Work from home where possible. You employer should support this.
- No gatherings of more than 2 people (unless they are members of your household). That means you cannot meet other family members who don’t live with you and friends. You can still keep in touch using phone/internet.
- Daily exercise is allowed but limit this to an hour per day and keep your distance from others
- Use telephone or online services to contact your GP for anything urgent
You can leave your home for essential reasons such as shopping for necessities and for medical appointments.
Why do we need to social distance?
The coronavirus mainly spreads by droplet. If you imagine coughing, every time you cough, invisible droplets come out of your mouth and nose. These could contain the virus. These droplets fall to the ground and cover your clothes and other nearby surfaces. The distance that a cough could travel is up to 2m and that’s why we recommend keeping that distance between people.
If we keep our distance it means that other people are less likely to get the virus from you and you are less likely to get it from them. This will reduce the spread of the virus.
Who should be doing it?
Everyone should be social distancing. There are no exceptions to this.
What else should I be doing?
This virus travels by droplet and can live on surfaces. You are most likely to get it by touching an infected surface such as a door handle and then touching your face. The more this happens, the more likely you are to get the virus.
Wash your hands regularly and frequently with soap and water for at least 20 seconds. It is important to wash between the fingers, the thumb and back of your hands as these are the areas that people often neglect. Ineffective hand washing means the virus could still be on your hands even if you think they are clean.
Hand washing is the best way to protect yourself. This is probably the most important thing for you to remember.
What is self-isolation?
Self-isolation involves doing the following. You must:
- Not leave your home for any reason and try to stay 2 metres (3 steps) away from other people in your household
- Wash your hands thoroughly and frequently to avoid passing on the virus
- Not go out to buy food or collect medicine. Please ask someone else to drop them off at home. Avoid face to face contact as much as possible
- Not have visitors, such as friend or family, in your home and do not visit anyone.
Who should self-isolate?
Self-isolation is for people who have symptoms of Coronavirus (new continuous cough +/- high temperature) or live with someone who does.
A new continuous cough is defined as coughing excessively for more than an hour, or 3 or more coughing episodes in a 24 hour period. If you usually have a cough then you should be looking for a cough that is worse than your usual baseline.
A high temperature is defined as 37.8 degrees or higher. If you do not have a thermometer then you might note that you feel hot to touch on your chest or back. When checking a temperature it is useful to use the back of your hand to feel rather than the palm.
There are other symptoms of the virus that we are learning more about. Losing your sense of smell and getting short of breath are two other symptoms to watch out for. If you suspect you might have coronavirus it is safer to be more cautious and self-isolate.
How long should I self-isolate for?
The answer to this depends on if you have coronavirus or are living with someone who does
If you have symptoms of coronavirus, you need to self-isolate for at least 7 days. After 7 days if you do not have a high temperature, you do not need to self-isolate any longer. If you still have a temperature, you must continue to self-isolate until your temperature returns to normal.
If you live with someone who has symptoms of Coronavirus, then everyone in that house will need to self-isolate for 14 days from the day the first person’s symptoms started. This is where most people go wrong and get confused especially if you have children who get a temperature. Temperature symptoms in children are very common but at the present time, the recommendation applies to children as well so if any child at home gets a cough or temperature than the whole household needs to self-isolate.
The reason for 14 days self-isolation for the household is due to the time it may take for someone to develop the disease and show symptoms. If during the 14 days self-isolation you should develop any symptoms suggestive of coronavirus then you will need to self-isolate for 7 days from the date of onset of symptoms.
Should I get medical help if I am self-isolating and have/might have coronavirus?
The simple answer to that is no. For the vast majority of people who get coronavirus, the symptoms will last about a week or so and start to improve. However, for some people their symptoms may start to deteriorate and get worse. These people should get medical help either through NHS111 or through us.
Hospitals are still open, but we are trying to reduce the number of people going to hospital currently. If there is an absolute emergency, you can attend A&E, but please think very carefully about whether it is an emergency. You can contact NHS111 and us if you are unwell and need help or are not sure what to do.
How do I know if I have coronavirus and can I get a test through my GP surgery?
All testing is done by the hospital and at present it is only being used for people being admitted to hospital and for front line medical staff with symptoms who might otherwise be taken away from important clinical roles. We cannot organise tests for you.
What is shielding?
As explained above, for the vast majority of people, getting coronavirus will make them feel ill but it will pass as we would expect any other viral illness to do. However, we know that the coronavirus can be particularly dangerous for certain groups of people. If these people were to get the virus, the risks to their health could be far greater including serious lung problems and unfortunately in some cases it can lead to death.
Shielding is a way of protecting those people who are at the highest risk from coming into contact with the virus by reducing their interaction with others as much as is possible.
What do I do if I have been told to do this?
You should stay at home at all times for a period of at least 12 weeks. You should have received a letter from the NHS explaining this and we have also contacted every patient on this list individually so if you have not been contacted then you are not in the highest risk group.
You may still have visits from carers and essential healthcare. Everyone entering the home should wash their hand for 20 seconds on arrival.
Who should be shielding?
The list of people who should be shielding is very small. To give an example, only about 1.5% of our practice population fall into this group. The definitions for who should be shielding are very specific. These people are at very high risk of severe illness from Coronavirus and should self-isolate for 12 weeks.
- Organ transplants patients
- People with certain types of cancer treatment
- Blood or bone marrow cancer, such as leukaemia
- Severe lung conditions, such as Cystic Fibrosis or severe asthma.
- People taking medications that weaken the immune system.
- People who are pregnant AND have a serious heart condition.
It should be noted that even if you have asthma and Chronic Obstructive Pulmonary Disease (COPD) and use inhalers, your condition may not be classified as severe enough to warrant shielding advice. Please note that the conditions for shielding are pre-set by Government and have been drawn up by national experts. The database is centrally administered. If you fall in this group, you will have received a letter from the practice and will have been followed up by a phone call and text message.
More information can be found on the following government advice page https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19.
General practice appointments
Why can’t I see my GP anymore?
You can still see your GP but to protect all of us, we have decided to see patients using a wide range of other methods. All the local GPs are working in a similar way. Face to face appointments are only happening in exceptional circumstances. Online appointment bookings have now stopped.
How can I get medical help?
Generally, there are four types of appointment and ways to get help. The first type of appointment is the one that most people will be familiar with:
- Face to face appointment- this is only made in exceptional circumstances. Please do not attend the surgery if you are ill with any symptoms suggestive of coronavirus. Only attend the surgery if you have been contacted and told to come in otherwise you will not be seen.
The other types of appointment may be less familiar to most people. They are new ways of working but they offer increased flexibility and most importantly they allow for medical care to still happen when everyone is social distancing:
- Video consultation- this is a useful alternative to a face to face appointment. It allows you to see the health care professional and he/she can see you. It is particularly useful when an examination may be required such as to look at a rash and observe a sick child. You can request this when making your appointment if you think it is needed for your problem. Alternatively, the health care professional may ask to see you in this way to better understand your problem and help them with your management. The video is totally secure and you will receive a text message which contains a link to the video that you need to click on. The consultation takes place through your phone and the health care professionals phone using the camera.
- Telephone consultation- this is familiar to most people, but we are now using this more and more to maintain social distance. Almost any medical problem can be discussed by phone. It allows a conversation to happen flexibly and keeps you safe. We are using these to discuss many different medical problems with people including both mental health and physical health.
- E-consultation- this is a relatively new addition. You can use an e-consult for almost any medical problem and it is particularly useful for administrative problems like letters and sick notes. It allows for much quicker response from us and the tool we have will ask you some basic questions to try and support you. If you have a clinical problem, the e-consult will ask medical questions so please answer them as best you can. This is then sent to the GP who looks at your answers. We can either reply directly back to you, send a prescription for you or arrange to speak to you if we need more information.
It is important to note that nursing appointments are still available. The same tight regulation occurs and we ask you all to be diligent and inform us if you have or suspect you have coronavirus before attending your appointment. The nurse is still seeing people for routine immunisations, injections and dressings.
I need a referral to the hospital/ I am waiting for an appointment, what will happen?
The local hospital(s) and indeed every hospital in the country is under a lot of pressure at present and they a running a greatly reduced service. It is very likely that most if not all routine care will no longer take place or if it does so, it may be done remotely by phone or video in much the same way that we are having to work at present. If your referral has already been sent, then it is likely there will be a delay in processing it. It is impossible to predict what will happen and when normal service will resume. It would not be unreasonable to say that the next 3 to 6 months will cause a huge disruption to routine care.
If you would like a new referral, only very serious conditions will be referred, but there is still likely to be a significant delay. Most routine referrals will not be sent at present and you will need to speak to a GP when services have returned to normal if your problems persist.
I need to have a scan and/or x-ray
As with hospital appointments all imaging such as routine scans and x-rays has been heavily reduced. In many cases, it is no longer happening. Urgent scans are still taking place in some instances but the system is experiencing delays and scans are being prioritised for people who are sick in the hospital rather than for those in the community.
I/My relative has an appointment at the hospital?
The hospital is still open, but people are advised to attend the hospital only if it is absolutely necessary and if they have been told to do so. Where it is possible, you may be contacted by the hospital and have a telephone appointment instead. This is for your own safety and to reduce the spread of the virus.
You may be contacted by the hospital and informed that your appointment has been postponed or cancelled. We apologise if this is the case and you can be re-referred when services return to normal. If you are unable to attend your appointment, please inform the hospital beforehand.
The following information covers some other questions and queries we have been receiving from patients.
You will no doubt be aware of the problems that stockpiling has caused for shopping and getting essential items. Unfortunately, we are starting to notice the same may be happening with medications. There is absolutely no need to stockpile medications. This is not necessary and disadvantages others who may be more in need. The local pharmacies have normal and sufficient supply and medication supply chains are not affected.
To mitigate stockpiling, you may notice that you can only get one month of medication at a time in some instances. We will do our best not to inconvenience you and we are not trying to make things more difficult for patients but we need to be there for everyone and have a duty of care. If we notice medication request trends changing we may enforce tighter prescribing controls.
For most people, prescriptions will continue as normal and you should see few changes. Where medications are changed to once a month, we will be able to issue a prescription for 3 months to the pharmacy but this will only be dispensed one month at a time. This will save you having to keep requesting it from us and you will only need to collect it every month from the pharmacy.
Can I get my medication delivered?
This will be down to individual pharmacies and their capacity. Medication delivery is likely to be limited to those who are housebound and shielding in the first instance.
If you are struggling to get a medication delivered, you can try Phlo which is an app that you can sign up to for your prescriptions to be ordered and delivered (www.wearephlo.com). It is a free service.
I need an inhaler which is not on repeat. I had asthma a long time ago, can I get an inhaler?
If you are having shortness of breath, cough or chest tightness and feel you need an inhaler, please contact us. If you have not needed an inhaler for quite some time and are thinking you need something “just in case”, it is unlikely that you will need one now. You can contact the practice during opening hours to discuss this if you develop symptoms.
I need my contraceptive pill, can I request this without review?
Your contraceptive can continue for 3 months if you are not having any problems with the medication, without the need for a blood Pressure and weight check.
I have other medical problems, should I be worried?
This depends on what medical problems you have exactly. Many people have other health problems such as diabetes of any type, asthma and high blood pressure. The advice at present is that you should be social distancing. Because you have other health problems you should be extra cautious but it is not required that you shield yourself and isolate for 12 weeks unless you fall into the highest risk group.
I have/don’t have other medical problems, but I am over 70 years old. What should I do?
The advice remains the same. You should be extra vigilant and social distance. You are not required to isolate for 12 weeks unless you have been told to do so.
I am self-isolating, can the Doctor give me a sick note?
If you (or someone you live with) have symptoms of Coronavirus and you are unable to work, you do not need to request a note from the doctor. You can use this link to get an isolation note https://111.nhs.uk/isolation-note.
By law, medical evidence is not required for the first 7 days of any illness. After 7 days it is down to the employer to determine what evidence they require. This is not mandatory, and it is entirely discretionary. The government has urged employers to respect the current rules and need for people to stay at home.
The surgery will not be issuing any medical sick notes for periods of coronavirus related illness and self-isolation. This is because these notes are not required and due to the volume of notes, they are a huge drain on our already depleted resources. They take health care professionals away from doing other important work looking after people who are sick.
I don’t want to go to work as I have a medical problem and my employer is asking for a sicknote
This is one of our most frequent requests at present and it is a huge and unnecessary drain on our resources. Whilst we fully understand the position that patients and employers find themselves in, this might be a personal choice that you are making. That is entirely understandable. We would encourage you to have an open conversation with your place of work and share your fears and reasons for not wanting to work. It is worth exploring with them how they can support you to continue working such as working from home or changing your duties.
Unfortunately, we will not be able to issue you with any documentation to share with your employer. This needs to be a conversation between you and your employer and there will be no provision of supporting documentation and letters from us in that regard. You can access your own health records and medical problems online should you need to.
People who are at the highest risk will already have been contacted by the NHS and by us and provided with relevant documentation to show to their employer should they need to as they are being specifically asked to shield themselves.
I need a new sick note for something else not related to coronavirus, how do I get this?
You do not need an appointment with the doctor for a sick note alone. You can request this online via e-Consult https://springfieldmc.webgp.com/.
Please do not make phone appointments for sick notes. Many of these queries can be dealt with using our website and online resources. Please be mindful of this when booking appointments.
How can I help the NHS?
Many NHS workers including ourselves have been touched by the kind words and thanks we have had during this difficult time. We don’t ask for this but it is warmly received.
Our final plea to all our patients is to look after each other. You can do that by following the guidance above especially social distancing and handwashing. Be very careful what information you read online and what source it has come from. There is a lot of unverified information circulating and you should be very careful taking some things at face value. We will continue to update this document as things change so please keep checking back for more support and if there are specific questions, we can help answer and share them here.
Finally, if you able, you can sign up to be a volunteer and help others who may be struggling. There is a role for all of us to play at this time.