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Dr Wordley is hanging up his stethoscope at the end of March. Please read his message to you all and also leave him your good wishes or type the shortcut ivy.gs/wishes
Access to a GP is now via the eConsult online consultation service. This involves completing a simple online form to get advice and treatment from us.
If you need help from us, or want to find out more, please go to our eConsult page or type the shortcut ivy.gs/econsult.
Visit our General Practice 2.0 page for detailed information on how we are managing your specific conditions during the coronavirus pandemic or type ivy.gs/gp2.
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Novel coronavirus, officially named COVID-19 by WHO, is a new respiratory illness that has not previously been seen in humans and which was first identified in Wuhan City in China.
Coronaviruses as a group, are common across the world, and cause symptoms including fever and a cough that may progress to a severe pneumonia causing breathing difficulties.
This coronavirus is classed as an 'airborne high consequence infectious disease'.
Hundreds of thousands of patients in the UK have tested positive for coronavirus and nearly 50,000 people have sadly died from it.
If you are concerned you might have coronavirus, please do not come to the surgery. This is official government advice.
The following is a brief timeline of UK response:
A high temperature (37.8°C or more if you have a thermometer, or if you feel hot to touch on your chest or back if you don't have a thermometer)
A new cough you haven't had before, or if you usually cough, it has got worse, and where you are coughing a lot more than an hour, or 3 or more coughing episodes in 24 hours
Smell and taste are deeply connected, so this applies to either or both sensations - if you have noticed you cannot smell or taste anything, or things smell or taste different to normal
high temperature new continuous cough loss or change of smell or taste
Most of the following is good practice for everyone, to reduce infection risk in general
By turning up at surgery, you risk the surgery being placed into a state of lockdown and you will be putting yourself and others at risk. This cannot be stressed enough!
Please do not come to surgery.
Use the 111 online service or ring 111 if no online access.
If you have a high temperature new continuous cough loss or change of smell or taste then you should self-isolate as defined above.
Your GP cannot 'check you' to tell you if it definitely is coronavirus or not and your GP does not have any access to testing. You need to self-refer for testing if you have symptoms.
Given community spread of coronavirus, you might well have it if you develop the above symptoms. It is therefore very important that you self-isolate to prevent further spread of infection. This is to protect yourself and others. Please do not come to surgery.
There is no specific treatment for coronavirus, antibiotics do not help.
Find out what to do if you are getting worse
Read guidance on staying at home
Follow guidance on keeping safe while isolating at home
Follow precautions to prevent spread of infection
See Why can't I come to surgery?
Next time, please consider having a flu jab if you are eligible
In general, those more vulnerable to complications on contracting coronavirus are those patients who are over 70, have underlying long-term conditions, or pregnant women.
If you are eligible to have a flu jab on medical grounds each year, then you are likely classed as vulnerable.
Those classed as vulnerable will not receive any notification from the NHS or from their GP. If you fall into a vulnerable group, you are strongly advised to follow social distancing guidance.
Whatever medical condition you have, the best way to remain well is to avoid catching it in the first place.
Read guidance on social distancing
Follow precautions to prevent spread of infection
Five things you can do to protect yourself and your community
Practical things you can do to help flatten the curve
Read guidance on shielded patients and see immediately below
If you are in a vulnerable group and feel you need help at home, find out more here
Those on the shielded list should not attend work, school, college or university, and limit the time spent outside the home. Those shielding should only go out for medical appointments, exercise or if it is essential.
Those on the shielded list will be sent a letter directly from NHS England and can opt in to have vitamin D delivered directly to their door.
Care home patients who are on the shielded list will get their vitamin D from deliveries sent directly to care homes.
For all other patients, government advice is to take a daily 10 microgram vitamin D supplement over Autumn and Winter, which they can buy directly from pharmacies, supermarkets and other retailers.
There is therefore no need for GPs to prescribe vitamin D for shielded patients or ro any other patients outside of any other local guidelines. We kindly ask that you do not ring us, or book an appointment or request that we prescribe vitamin D.
New guidance has been issued in light of the new national lockdown.
The shielding list now includes adults with Down's syndrome and those patients with chronic kidney disease at stage 5. These additional patients will be identified and contacted.
Paediatric specialists have reviewed the evidence on risk levels posed to children and young people from coronavirus infection and the latest evidence indicates that the risk of serious illness in most children and young people is low, even if they have pre-existing medical conditions.
GPs have been asked to review the risk status for all children and young people (under 18 years old) on their practice list currently flagged as very high risk and to amend the flag to record a lower risk as clinically appropriate.
We will be contacting the consultant specialist for any child in this category and will get in touch with any decisions in due course. Please bear with us whilst we do this work.
We urge all patients on the shielding list to read the current guidance on shielded patients.
Some patients are classed as being at very high risk of severe illness requiring admission to hospital if they were to contract coronavirus. Such patients are being identified by the NHS centrally and also by their GP.
Those at extremely high risk will be advised to shield. This is a measure to keep these people safe, and essentially means staying at home at all times, and avoiding any face-to-face contact for at least 12 weeks.
Read guidance on shielded patients
If you are in a vulnerable group and feel you need help at home, find out more here .
Follow precautions to prevent spread of infection
Five things you can do to protect yourself and your community
Check and/or register for support
You have several options on getting help if you are vulnerable or extremely vulnerable:
Download all the above links as a document you can print out.
Information for carers can be found on our Carers page
This service can help if you have no friends or family you can call on and:
They can help with shopping, fetching prescriptions or finding someone to have a chat with.
If you need help you can use the link below to register or you can ring 01629 535091 - Monday to Friday 9am to 5pm, Saturday 9am to 1pm, or email ASCH.CommunityResponseUnit@derbyshire.gov.uk.
Derbyshire's Community Response Unit .
Requests are sent out to community partners such as AV CVS to fulfil.
Download an information leaflet .
Amber Valley Community Volunary Service (AVCVS) is based in Ripley, Derbyshire and is the local organisation for the district’s voluntary sector and the main provider of support for local voluntary and community groups.
AVCVS offers a range of support and services to respond to the needs of volunteers, voluntary organisations and community groups.
Email Paulclarke@avcvs.org or ring 01773 748688.
You can now request an NHS volunteer through GoodSAM and NHS volunteers and access a variety of different support options:
Check in and chat support to individuals who are at risk of loneliness as a consequence of self-isolation.
Community support provides collection of shopping, medication or other essential supplies for someone who is self-isolating, and delivering these supplies to their home.
Patient Transport support provides transport to take patients home who are medically fit for discharge.
NHS Transport support provides transport for equipment, supplies and/or medication between NHS services and sites. Also involves assisting pharmacies with medication delivery.
Find your local coronavirus support group at Covid-19 Mutual Aid .
Covid-19 Mutual Aid UK is a group co-ordinating local support for the most vulnerable in our communities.
In this area, there is the Ripley Community Covid Support Group and Corona Virus Helpers Heage And Surrounding Villages .
Contact the Royal Voluntary Service for help and support.
The Royal Voluntary Service co-ordinates olunteers providing much-needed support for over-stretched public services and for people as they age.
Ring 0330 555 0310, 9am to 5pm Monday to Friday.
If you are in an extremely vulnerable group, you can officially check and/or register for support here .
Your NHS needs you!
NHS Volunteer Responders has been set up to support the NHS during the coronavirus outbreak. To do this the NHS needs an 'army' of volunteers who can support the 1.5m people in England who are at most risk from the virus to stay well.
Find out more about NHS Volunteer Responders .
See also Covid-19 Mutual Aid UK which co-ordinates neighbourly initiatives and has lists of local groups in your area,.
The Royal Voluntary Service is a national charity built on local volunteering giving support to the people that need it in hospitals and communities.
If you are a business looking to help in the efforts against coronavirus, and can provide help such as protective equipment like masks, gowns and sanitiser, medical equipment, logistics, please register the support of your business .
If you have a high temperature new continuous cough loss or change of smell or taste then you should self-isolate as defined above.
Given significant community spread of coronavirus, you might well have it if you develop any of the above symptoms.
Anyone with symptoms (including children) can get a swab (antigen) test for coronavirus - please see links below.
Get a coronavirus test
Ring 119 to request a test if you have no internet access - however, in our experience, you may have better success gettting a test if you use the online service (or ask someone who can request a test on your behalf), rather than ring up
Read about your test result
Read guidance on staying at home
Follow guidance on keeping safe while isolating at home
Follow precautions to prevent spread of infection
See Why can't I come to surgery? below
Please visit our new website page which we have set up to provide the latest information on covid vaccination.
Covid vaccination page SHORTCUT ivy.gs/covid-vacc
Schools, colleges and other educational settings are working very hard to review the government guidelines alongside their own risks assessments to determine the safety of a phased reopening of their institution.
These measures are overseen by the head teacher, the senior leadership and appropriate governing body (or equivalent) for each school’s individual circumstances.
Parents/carers need to work with schools if they have individual concerns about their child.
It is the parents' and carers' choice as to whether they feel it is safe, and not for a GP to decide.
Teachers and other employed staff will also need to work with schools if they have concerns about their own health and whether they can safely return to face-to-face work.
GPs have not been provided with additional/specific guidance regarding decision making for staff or students beyond current public health measures.
Please follow this link from the Royal Collage of Paediatrics and Child Health which states that:.
Children who live in a household with someone who is extremely clinically vulnerable and shielding should only attend if stringent social distancing can be adhered to and the child or young person is able to understand and follow those instructions.
Children and young people who live with someone who is clinically vulnerable (but not extremely clinically vulnerable) as defined in the social distancing guidance and including those who are pregnant, can attend.
GPs will not be issuing notes or letters on behalf of parents or carers if they do not wish to send their child to school or their child is shielding for themselves, or to protect family members who are shielding and/or vulnerable.
In addition, GPs will not be issuing notes or letters to confirm over-the-counter medicines, or prescribe them so that schools or nurses have an 'official' record of a prescription for them to administer.
The Department for Education has confirmed to the BMA that a prescription is not required and non-prescription medication can be administered where parents have given written consent.
We kindly ask that you do not book an appointment to request such letters pr prescriptions from us.
BMA guidance on over-the-counter medicines
With children returning the school, the usual coughs and colds will start to circulate again. Current advice is that children do not need a covid-test and do not need to self-isolate if they are simply suffering from a common cold.
Symptoms frequently seen with common colds are runny or blocked nose, aches and pains, sneezing and sore throat. Adults and children with a common cold are generally not acutely unwell.
If a child is more poorly with a heavy cold, then they might need a day or two off to recover. Keep off school as you would have done pre-covid.
If a child has definite coronavirus symptoms with high temperature new continuous cough loss or change of smell or taste then you must follow the guidance and self-isolate and test as above.
Other viruses will circulate during winter as they did before coronavirus; we advise that parents follow the guidance on viral illness as above. There is no need to contact a GP because your child has a cold or sniffles, unless they are unwell.
If your child is under the care of a paediatric specialist or was previously shielding due to a long-term health problem, then we advise you to seek specialist advice, or you should follow any advice previously received.
Download our leaflet How can I tell if my child is poorly
Find out about coronavirus in children
Common cold and COVID-19 symptoms - advice from RCPCH
Guidance note from Derbyshire LMC for parents
Read guidance for parents and carers
Read guidance for school opening
You should be following directions for self-isolating as described above.
If you are a confirmed case of coronavirus, you might be transferred to and cared for in a specialist centre, or if your symptoms are mild, you might be advised to self-isolate at home, either by Public Health or 111.
You may have fever, cough or breathlessness or general viral symptoms or only mild or even no symptoms.
There is no specific cure for coronavirus. Any treatment aims to relieve symptoms only, which for a viral illness includes rest, paracetamol and plenty of fluids - please follow NHS advice .
Find out what to do if you are getting worse
Read guidance on staying at home
Follow guidance on keeping safe while isolating at home
If you develop symptoms, or become unwell, use the 111 online service or ring 111 if no online access
Follow precautions to prevent spread of infection
Use the 111 online service or ring 111 if no online access:
Example of getting worse might be:
Ring 999 if you are very poorly, and inform them of your symptoms and that you are self-isolating.
Anybody can use the 111 online service to find out what to do next. Please do not come to surgery.
Read guidance on staying at home
Follow guidance on keeping safe while isolating at home
Follow precautions to prevent spread of infection
See Why can't I come to surgery? below
Current guidance is that hydroxychloroquine and chloroquine should be used only as part of a clinical trial for the treatment of coronavirus.
Dexamethasone is approved to treat all UK hospitalised COVID-19 patients requiring oxygen, including those on ventilators, from June 16, 2020.
If you do not already take such medication, We kindly ask that you do not book an appointment to request them.
With regard to vitamin D, please read the update posted under shielded patients.
We will not prescribe them to you. Repeat prescriptions will continue to be issued to those existing patients with current clinical need for these medications and for licensed purposes only.
You should be following directions for self-isolating as described above.
After 10 days, if you feel better and no longer have a high temperature, you can return to normal activity.
If you still have a high temperature, continue to self-isolate until your temperature returns to normal.
You may still have a cough for some weeks after, this is normal. It does not mean you have to stay at home for more than 10 days.
If you do not get any better, continue to self-isolate and 111 online service. Please do not come to surgery.
Anybody can use the 111 online service to find out what to do next. Please do not come to surgery.
Read guidance on staying at home
Follow guidance on keeping safe while isolating at home
Follow precautions to prevent spread of infection
See Why can't I come to surgery? below
In a situation such as this, self-isolation would be advised officially by 111 or Public Health for contact with a confirmed case, or a suspected case, or whilst awaiting results of a coronavirus test.
By law, a doctor's fit note (sick note or MED 3) is not required for the first seven days of sickness absence.
After seven days, a doctor's note may be required - it is actually for the employer to determine what evidence is required, if any, which may or may not be a doctor's note.
The government strongly suggests that employers use their discretion around the need for medical evidence for a period of absence where an employee is advised to self-isolate in accordance with Public Health advice being issued by the government.
This means that a doctor's note will not necessarily be required. Please download this information sheet .
Use the new 111 isolation note service
Emergency legislation is being brought in to allow employees to claim statutory sick pay from the first day off work in order to help contain coronavirus.
Please note, if you are not following any official 111 or Public Health guidance to self-isolate, but you have made the decision yourself to do so, you are not entitled to a doctor's note at all in this situation.
For queries regarding requests for GP letters related to the coronavirus pandemic, please see our GP letters section immediately below.
Read guidance on working safely
Read guidance on staying at home
Follow guidance on keeping safe while isolating at home
Follow precautions to prevent spread of infection
If you have changed your mind and decide not to go on holiday, you do not need a letter from the GP.
Insurers and travel companies should be basing their decisions to offer refunds on advice from the Foreign and Commonwealth Office and Public Health England, not letters from GPs. Professor Martin Marshall, chair of the Royal College of GPs
Please check foreign travel advice
Please check foreign travel advice by country
Please check our forms and documents policy where it states that we are happy to complete travel cancellation forms if we have been attending you for medical conditions for which we have advised that you cancel or postpone your holiday. We will not write a letter for any other reason.
We kindly ask that you do not book an appointment to request such letters from us.
If you are going away, please check out this infographic guide on staying safe.
If you need a note for your employer because you are self-isolating due to coronavirus or have coronavirus in your household, please see our information on self-isolation or use the shortcut ivy.gs/covid-isolationnote. We will not supply sick notes for self-isolation purposes.
If you are in the shielding group, you will have received a text or letter from the NHS or ourselves about this. You can use this letter as evidence for your employer or others, and there is no need for a further letter from us to confirm your status.
GPs are not in a position to perform or sign-off on any risk assessment for you in your workplace - this is your employer's responsibility.
GPs are not in a position to authorise any return to work or home-working plan - this is for your employer or the human resources or occupational health department.
We kindly ask that you do not book an appointment to request such letters from us.
Should your employer need specific medical information about you or a formal report about your condition, we will not be able to provide such information to them without a copy of your written consent. Such information will be subject to a fee as this is private work not covered by normal NHS service. If a formal report is required, please ask your employer to put such requests in writing to us, enclosing a copy of your written consent.
GPs are not in a position to provide letters for schooling.
Please see our dedicated section regarding coronavirus and schooling or use the shortcut ivy.gs/covid-school.
We kindly ask that you do not book an appointment to request such letters from us.
GPs are not in a position to provide individual risk assessments or letters for patients to authorise any exemption from wearing a mask.
Face coverings are not to protect you. However, if you are infected but have not yet developed symptoms, it may provide some protection for others you come into close contact with. From a public health point of view, we cannot authorise you to not wear a mask where it is deemed appropriate or regulated by law.
The legislation states that: No person may, without reasonable excuse, enter or remain within a relevant place (e.g., shops, public transport) without wearing a face covering. The only reasonable excuses for medical purposes for not wearing masks are if someone cannot put on, wear or remove a face covering— (i) because of any physical or mental illness or impairment, or disability (within the meaning of section 6 of the Equality Act 2010), or (ii) without severe distress.
At no point does the legislation or any other regulation require GPs to provide letters of confirmation of these conditions, or to authorise exemption from wearing a mask and we therefore politely decline such requests for letters. Self-declaration is sufficient and patients wishing to do so may download and use the resources indicated below.
We kindly ask that you do not book an appointment to request face covering exemption letters from us.
Download a Derbyshire LMC information sheet
Read guidance on face coverings
Download and print face covering exemption card
Download face covering exemption file for mobile
This issue has nothing to do with GPs regardless of who has requested this letter. You have various options:
We kindly ask that you do not book an appointment to request such letters from us.
We understand that due to the pandemic, DVLA have a backlog with licence renewals so are advising people they may be able to continue to drive under section 88 of the Road Traffic Act. This may allow you to continue driving even though you do not hold a current driving licence. In practice, this will be when you have applied to the DVLA to renew your licence, but the licence expires while they are processing the application.
However, DVLA are advising people that in order to meet these criteria a GP must document their fitness to drive and a number of practices have received such requests.
The declaration that an applicant is fit to drive must be made by the applicant NOT the GP (s92 of the Road Traffic Act).
Any medical decision about fitness to drive is made by the DVLA in-house medical team, not GPs.
It is not the responsibility of GPs to help DVLA clear their backlog.
We kindly ask that you do not book an appointment to request such letters from us.
You may have residual symptoms after having had coronavirus infection. This is a new condition and more information regarding after effects of infection are emerging.
Please see our dedicated section regarding post-covid recovery or use the shortcut ivy.gs/covid-postcovid or ivy.gs/postcovid.
If you are well, the best way to remain well is to avoid catching it in the first place.
This advice applies whatever medical condition you have.
Follow precautions to prevent spread of infection
Five things you can do to protect yourself and your community
Practical things you can do to help flatten the curve
Keep up with updates on coronavirus with the links below or follow this page. We will try to keep this page regularly updated with the changing guidance, as long as we've not been taken out by someone infecting us.
We will aim to keep this page regularly updated with the changing guidance, as long as we've not been taken out by someone infecting us, so please do not come to surgery if you have it.
These are very anxious times for everybody.
Because this virus is entirely new, no-one physically, or figuratively, is immune from its effects.
Everybody has been affected in some way, be it, with colleagues self-isolating or sick, with workplace changes, with national lockdown. One cannot help but be moved by the tragic stories we hear all around the world.
If you feel you need more help and support, please visit the new mental health section of our General Practice 2.0 page or use the shortcut ivy.gs/covid-mentalhealth. We have built this page specially to help those who are struggling with their mental health during this current crisis.
NHS staff who are finding their mental health is being affected during this pandemic can visit a special section on this page for staff, or use the ivy.gs/covid-staffhealth.
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© Dr Michael Wong 2021