A message to North Lincolnshire residents from Dr Faisel Baig:
Dear North Lincolnshire Residents
I wanted to provide some clarification around face-to-face consultations in General Practice.
General Practice has had to undergo a transformation during the coronavirus pandemic. The health and safety of our patients and our staff has been our absolute priority. Earlier this year, this meant asking patients or their carers to contact practices by telephone or online, rather than initially attending practices. Clinical consultations have been taking place through telephone, video, online portals or face-to-face, depending on the clinical and personal needs of our patients. Bringing significant numbers of patients into General Practice waiting areas amplifies virus transmission. It was essential to implement such steps to limit the spread of the virus when there were significant numbers of coronavirus patients at the peak of the pandemic. These steps still remain important.
Telephone, video and online consultations, where appropriate, have not only helped limit the spread of coronavirus but many patients have given feedback that suggests they have found them particularly convenient. Especially where subsequent prescriptions have then electronically been sent to pharmacies that patients have chosen.
I, and many GPs I have spoken with, have found these remote consultations very difficult at times, as it has not been easy to build personal relationships with patients or pick up many of the non-verbal cues that come to our attention when seeing our patients face-to-face.
I would like to reassure everyone that face-to-face consultations are offered, where clinically appropriate, or if a patient or their carer is unable to access, or use, a telephone, video or online consultation.
During these difficult times, our General Practice teams have not only continued to provide face-to-face consultations within practices but local GPs have also staffed other important services. These include a specialist community Covid Isolation Clinic, a dedicated GP visiting service for our shielded patients, the local Urgent Treatment Centre and our GP Out of Hours Unit.
Our General Practice teams are here for you, and have been, throughout the pandemic, providing many thousands of appointments across North Lincolnshire. I am proud of the way General Practice has responded and I want to reassure you that we will continue to offer face-to-face consultations, where they are indicated.
These are challenging times for all of us and your patience and support are highly appreciated by your General Practice teams.
Dr Faisel Baig
Chair, NHS North Lincolnshire CCG
To contact your local GP services:
Telephone your practice or 111 (in the evenings and at weekends) or go online – directly to the practice website, through the NHS App or through 111.nhs.uk
New process will give patients more say on their emergency care and treatment
A new process is being introduced to give residents across Northern Lincolnshire more say about what happens to them if they need emergency care or treatment.
ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) is a nationally developed process led by the Resuscitation Council (UK). ReSPECT creates personalised recommendations for a person’s clinical care in a future emergency, where they may be unable to make or express choices.
It is designed to allow patients greater influence on what happens to them, and that their wishes are carried out appropriately, should they ever find themselves in an emergency situation where they are not able to express their wants and/or needs.
ReSPECT can record preferences and recommendations for emergency situations, whatever stage of life the patient is at, and should not be limited just to those who are approaching end of life. In particular it should be an important consideration for those with significant frailty or chronic progressive long term conditions.
The nationally recognised process will start being rolled out across Northern Lincolnshire’s health and care organisations this September.
Dr Kate Wood, Medical Director and Consultant in Anaesthesia for Northern Lincolnshire and Goole NHS Foundation Trust (NLaG) said: “ReSPECT gives patients more control over their care, and reassures them that their views are being taken into account when decisions are made about their treatment.”
“In an emergency situation, staff must make rapid decisions about the care and treatment of an individual and there may not be time to have detailed discussions in a planned or sensitive way. It’s incredibly important to have these conversations early with patients to record their preferences for emergency situations. This ensures staff know how the patient wants to be treated, if at that point they are unable to make their wishes known, so their decisions can be honoured.”
Dr Yousef Adcock, Palliative Medicine Consultant for NLaG said: “Crucially, ReSPECT encourages wider open discussion about treatments that should be considered, as well as those that are not wanted or would not work, and should lead to agreed recommendations being made between the patient and healthcare professionals.”
Dr Rumman Afsar, General Practitioner for The Birches Medical Practice, and North Lincolnshire CCG’s Clinical Lead for End of Life Care said: “This process is a significant change of emphasis and a step forward from making ‘do not resuscitate’ decisions in isolation. Decisions will now be made based on the wider context of a discussion about potential treatment options.”
Dr Ekta Elston, General Practitioner for Roxton Practice, and Medical Director for North East Lincolnshire CCG said: “ReSPECT gives health professionals, patients and families the ability to have those important conversations that can make a vital difference to how a patient is treated and understood in emergency situations. They can be difficult conversations, ReSPECT helps it happen in a supportive sensitive way to ensure the best and most appropriate care and support is given to patients and their families when they need it the most.”
A North Lincolnshire health organisation will hold its first ever virtual Annual General Meeting (AGM) next month – and is encouraging members of the public to join online.
Due to the Covid-19 pandemic, NHS North Lincolnshire CCG will not hold the meeting in a public venue this year. Instead, the event, set to take place on 24 September, will be live streamed through the organisation’s Facebook page and YouTube channel. The meeting will take place between 2pm and 4pm.
Dr Faisel Baig, Chair of NHS North Lincolnshire CCG, said: “We are delighted to be able to invite colleagues, stakeholders and members of the public to join our virtual AGM this year.
“With many public events being cancelled due to the pandemic, holding the meeting virtually is our best option to ensure the safety of attendees and staff.”
Emma Latimer, Accountable Officer, said: “Our AGM is an opportunity to reflect on the past twelve months and to highlight areas of service improvement for the people of North Lincolnshire”.
Alex Seale, Chief Operating Officer, said: “This year’s AGM will still follow a similar agenda to previous years. We will take a look back on highlights and achievements from 2019/20, discuss our response to Covid-19, and explore the future and the challenges it may bring. We will also discuss our financial performance from the previous year, with a focus on how and where our budget was spent.
“We will finish with a question and answers session, but due to the event being virtual, we are asking for all questions to be submitted prior to the event by emailing NLCCG.email@example.com.”
I have chosen this quote from Henry Ford as the heading for this article, because in my view it encapsulates everything we need to do to overcome the challenge posed by this pandemic.
Amongst all the adversities caused by Covid-19, it has also played a major role in bringing families and communities together, to join hands against this common enemy. We are now in our second phase, where complacency can’t have a place, and our efforts to stick to our resolve will help prevent local outbreaks and lock downs. The National Health Service is now working hard to perform a balancing act of planning for a Covid-19 surge, working to prevent surges and also continue delivering routine care and services which have suffered in the last few months.
I am sure all of you can imagine this is not going to be straightforward and the usual capacity and waiting times will be adversely affected, and it cannot be achieved without collaborative working between service providers and service users.
Locally we are working very closely with our colleagues from North Lincolnshire Council, local hospital trusts and Public Health to plan and deliver good social, mental and physical wellbeing for our residents. I am very grateful for the efforts all of you have made to adapt to new rules of personal hygiene, social distancing and adjusting with changing models of care in primary and secondary care.
I would like to thank you all for your ongoing support and also appeal to your good self for ongoing understanding and support when you use any health and social services. I sincerely hope that you will be kind and patient whilst we all work hard to meet the health and social care demand in the best possible way.
Health and Care Partnership appeals for public support to help ensure services resume safely and promptly
NHS and council organisations in Humber, Coast and Vale are appealing for the public’s help as they work together to increase the availability of health and care services, which were restricted, relocated or paused during the coronavirus outbreak.
At the outset of the pandemic, health and care professionals including hospital teams, GPs, health visitors and social care staff responded quickly by changing the way they worked.
While some services are returning to how they were before, many of the changes made in response to the pandemic need to remain to maintain patient and staff safety and ensure services are prepared to handle any future increases in Covid-19 cases.
The public can play a pivotal role in helping to ensure that health and care services can resume safely and promptly. You can support your local NHS by:
Attending any appointments booked on your behalf
Consulting NHS 111 first if you are unsure which service you need
Only using A&E for emergencies
Being prepared to travel to a different location for appointments or treatment
Helping family and friends to get online so they can access online services if required
Dr Nigel Wells, Clinical Lead for the Humber, Coast and Vale Health and Care Partnership, said:
“We have to make some tough decisions about how we bring back services over the coming months. These decisions are being taken by the doctors and nurses in our hospitals and in the community. Our main concern is and always will be everyone’s safety.
“Many of our staff have been asked to work in new roles and locations; equipment has been moved to where it is most needed to care for people; we have fewer beds in our hospital wards as we have had to move them further apart which takes up more space; and we have to wait longer between procedures in our operating theatres to allow for deep cleaning and for the air to change.
“This all means that while some services are being restored to how they were before the outbreak, we can’t switch them all back on straight away and we hope people can understand the reasons why and bear with us.
“We are thankful for your patience as we resume services safely as quickly as possible and we need your help to do this. If you are asked to come to hospital or your GP practice for treatment, please do everything you can to keep your appointment so that we can see as many people as possible within the current constraints.”
Shaun Stacey, Chief Operating Officer, Northern Lincolnshire and Goole NHS Foundation Trust, said:
“The impact of the pandemic has been significant and continues to impact on how we run our services. I would like to apologise to all of those patients whose treatment was put on hold, and thank them for their understanding and patience.
“Our teams are working incredibly hard to bring services back on line, but unfortunately patients may still face waits to have their treatment or test. This is not what we would want but we have had to change the way we work to ensure the safety of patients and our staff.”
We have all witnessed rapid changes to services over the last few months due to unforeseen circumstances.
Healthcare, also, has not been the same, and traditional models of care are changing and adapting due to the challenges posed by the Covid-19 pandemic. Whilst we adopt new technologies and change how we provide safe and good quality of care to our patients, we have to be mindful of not creating a health gap.
As hospitals and GP surgeries provide advice and care on the telephone, video calls or via online consultations, I want to reassure you that we have not forgotten about the needs of those who can’t access healthcare using these new platforms. Our local commissioning group and local council have always believed in equal access to services and we have been working very hard to not create health inequalities amongst our population.
This pandemic has fast forwarded a lot of information and technology related changes and, as we have worked at pace to maintain essential services, we have been very careful to not marginalise anyone and create any inequality. Digitalisation is crucial for improving access to care and to facilitate innovative ways to deliver health care but digital inclusion has to run parallel to this so that we look after everyone in the same way.
The NHS Long Term Plan makes a commitment to a more concerted and systematic approach to reducing health inequalities and addressing unwarranted variation in care. At North Lincolnshire CCG, we acknowledge that some people will never use digital services directly but will benefit from others using digital services and freeing resources to help them. We are also aware that people with the greatest health needs are also the most at risk of being left behind and we will strive towards building digital services keeping this in mind, ensuring the highest levels of accessibility where possible.
I hope that you all will take necessary precautions to avoid a second wave whilst we work towards transforming local health care service without creating a gap.
Fourth primary care network developed in North Lincolnshire
Patient access to GP services has changed due to the Covid-19 pandemic.
The following information provides clear advice on how patients can access primary care services – whether that is virtually, remotely or, if appropriate, face-to-face:
NHS 111 and COVID-19 Clinical Assessment Service
Patients with symptoms of COVID-19 (cough, high temperature and loss of taste or smell), should dial 111 to access the COVID-19 Clinical Assessment Service (CCAS).
This service will undertake an assessment to determine if the patient requires further attention in primary care. It will be able to triage a patient and, if appropriate, book a patient in to a practice directly.
To access this service please call 111 for a clinical assessment.
Remote total triage
Remote total triage is a general practice programme which has been developed to support all GP practices in England during the COVID-19 pandemic.
It allows GP services to triage a patient remotely, prior to making a clinical decision. This enables practices to use an online consultation system to gather clinically relevant information from patients and triage patients – responding using the most appropriate modality to meet the patient’s needs such as via telephone, video, text, online or face-to-face.
Non-digital users are taken through the same process over the telephone.
To access this service please call 111 or your local practice before you attend in person for clinical assessment to prevent the risk of spreading the infection.
Online consultation systems allow patients to contact their GP surgery without having to wait on the phone or spend time traveling to the practice. They also form an important part of Digital First Primary Care.
Online consultations enable patients to ask questions, report symptoms and upload photos. The practice then looks at the request and responds within a stated timeframe, connecting the patient to the right person, service or support.
To access the online consultation service please access your local surgery via its website or contact your practice.
Video consultations enable patients to have an appointment via a completely secure video environment from the comfort of your own home. Patients do not need to attend the practice and can connect to this service.
To access the video consultation, please contact your practice. This service can be accessed following remote clinical triage.
Home visiting service
The home visiting service is a GP-led service to boost home visiting capacity for primary care. The service will support home visiting and care needs for shielded patients. Shielded patients with no Covid symptoms requiring face-to-face assessment should be seen via home visits unless an alternative care setting is clinically indicated.
To access to this service a GP will refer a patient via the Single point of Access (SPA)
Community Response Team Service
This service supports care homes and end-of-life patients. It is managed jointly with emergency care practitioner/social care/community teams, led by GPs, between 8am-8pm, seven days a week.
Care homes have direct access to this service and all Primary Care practices can access this via Single point of Access (SPA)
Appointments outside of normal hours are now available for patients. This includes weekday evenings (6.30pm-8pm), Saturdays (8am-8pm) and Sundays (10am-2pm).
Patients can book an appointment in their local area, in advance, by speaking with their usual practice. Following the passing of COVID-19’s peak this service will restart on July 1, 2020.
To access this service and to book an appointment, please call your practice.
Out of Hours service
The out-of-hours period is from 6.30pm to 8am on weekdays, and all day at weekends and on bank holidays.
To access this service For North Lincolnshire or Goole please call 111.
The hot clinic service is face-to-face consultations for patients with COVID-19 symptoms who require care.
For patients requiring a face-to-face assessment, either because of illness/complications related to suspected/confirmed COVID-19, or due to other long term conditions in the presence of suspected/confirmed COVID-19, should be remotely triaged by their practice to assess their symptoms and their need for a face-to-face consultation.
Patients can only attend hot clinics after they have been booked in for a specific appointment slot. Patients cannot self-refer in to this service.
Children with symptoms of COVID-19
COVID-19 tends to be a mild, self-limiting respiratory illness in children.
Prolonged illness and/or severe symptoms should not be attributed to COVID-19 and should be evaluated as usual. The threshold for face-to-face assessment in general practice and for referral to secondary care should not change during the COVID-19 pandemic.
To access this service, patients should call 111 for a clinical assessment.
Access to medication for patients with symptoms of COVID-19
Patients with COVID-19 symptoms should be advised not to go to community pharmacies.
If patients require a prescribed medication, this should be collected by someone who is not required to isolate themselves due to contact with the patient e.g. a neighbour or relative who does not live in the same household.
Alternatively, this can be done via NHS Volunteer Responders and delivered to the patient’s home. For information on how to use this service please call 0808 196 3646 (8am to 8pm) to arrange volunteer support. For more information please use the following link.
Mental health, dementia, learning disability and autism
Patients may feel distressed, anxious or low in response to the COVID-19 outbreak.
There are lots of online resources on mental wellbeing which includes information on stress, anxiety, depression, and wellbeing, and where to get urgent or emergency help for mental health needs. For more information please use the following links:
The Doncaster Talking Shop and the Improving Access to Psychological Therapies (IAPT) Long Term Conditions service have changed all their appointments to telephone/ video conferencing or Mind District online therapy programme.
Referral processes for both teams remain the same. Talking Shop self-referrals via Tel: 01302 565556 and IAPT Long Term Conditions is via Single Point of Access on 01302 566999 or direct office number is 01302 379563 for any other queries.
The Rotherham IAPT team can be contacted via telephone 01709 447755.
The North Lincolnshire Talking Shop on Market Hill, Scunthorpe is now OPEN for walk in referrals between 10am and 4pm Monday to Friday. The team is also taking telephone referrals on 01724 867297.
If your call is of an urgent nature please contact the RDaSH Crisis Teams on either 01302 566999; 01709 302670 or 01724 382015
People requiring translation and interpretation services
The move to remote consultation and use of PPE in face-to-face consultations requires additional considerations. For example, the impact of PPE on lip reading. The GOV.UK website provides advice for the public and is translated into multiple languages. The Doctors of the World has translated relevant NHS guidance into 60 languages.
Communication tips and BSL interpreters are available for supporting people with hearing loss to access general practice services.
Social and community support
Shielded patients are asked to register with the Government support website, whether or not they require additional support.
To access this, patients must be flagged as at highest clinical risk. There may be a short delay between the flag being applied and support arriving. If a patient requires more immediate support, refer to the NHS Volunteer Responders.
If you have access to a local social prescribing link worker or social prescribing service, they can co-ordinate support.
Preventing Coronavirus outbreaks in North Lincolnshire
A message for North Lincolnshire residents from the North Lincolnshire CCG Chairman/local GP and the North Lincolnshire Council Director of Public Health
As of July 1, 2020, there have been at least 10.4 million confirmed coronavirus cases worldwide and at least 500,000 deaths attributable to this most challenging disease. Countries such as China and Japan which had slowly been returning to normal have been reporting new infection outbreaks.
As lockdown measures in the UK are slowly being eased, we need to be cautious and vigilant. Leicester is an example of an area that has reported high numbers of infections and will be subject to specific measures to prevent the situation worsening.
So how do we ensure that North Lincolnshire infection rates do not rise and we tackle this virus robustly? There are steps that we have to take:
–Social distancing (between people not in your household). This should ideally be 2-metres. If 2-metres is not possible, then 1 metre plus – this involves sitting side-by-side or back-to-back rather than face-to-face where possible, safely keeping windows or doors open to allow ventilation, and avoiding talking loudly or singing as this can amplify virus transmission
–Strict hygiene including regular and rigorous handwashing (including the use of hand sanitiser where washing is not possible), sneezing/coughing into a tissue or the elbow fold, and regularly wiping down surfaces
– Wearing face coverings or masks whilst using public transport or in enclosed spaces, including in hospitals
For North Lincolnshire to overcomes this virus – each and every one of us has to play our part.
Dr Faisel Baig and Penny Spring