March 4, 2021

Dear Patients

This is our latest news update following on from the last one in January.

CASES STILL OUT THERE

We are now over the peak of the second wave with daily cases and hospital admissions reducing, however, the lockdown remains in place.

As the country cautiously reopens, we need to remind all patients that cases are still out there, with around 10 times as many new daily cases as when the first lockdown was lifted in July last year.

Therefore in this update, we provide some top tips for continuing to keep yourselves safe.

BE PREPARED TO HELP YOURSELF

As we continue to live with this pandemic, we urge everyone to do what they can to keep themselves safe. Here are 8 practical things that you can all do to help put an end to this pandemic.

1. GET TESTED IF YOU HAVE SYMPTOMS

Too many times we hear people say that the cough they have developed is just an ordinary cough, that they know their own body, that it can't possibly be covid...

If any of these were true, we would not all be living within a global pandemic right now.

Get a test if you have covid symptoms. Follow the rules about asymptomatic testing for workplaces (care homes, education, healthcare settings). Be very aware that covid tests are not completely accurate and can give a falsely negative result in many cases, so it is not a problem to repeat them again if you are still poorly, have continued symptoms or are getting worse.

If you have a positive test, follow self-isolation rules and allow contact tracing to do its job.

Getting tested, following self-isolation rules and robust contact tracing are ways out of the pandemic as proven by many countries that have high rates of compliance with all three of these areas.

2. BE HONEST WITH YOURSELF AND OTHERS

Related to the above really, but it is important to be honest with yourself and with others around you. Have you washed your hands properly, did you wear your mask properly and at all times, were you actually careful?

Did you socialise inappropriately or did you leave the house unnecessarily? Did you just minimise your covid symptoms, or ignore them, saying it was just a little cough and nothing to worry about, did you just go out or go to work when you should have been self-isolating, did you decide not to book a test thinking you would be OK?

Being less than honest with yourself would not really be a problem if that was all that happened, but it is precisely the impact that your choices and decisions have on others around you, your friends, your colleagues, your vulnerable family members, that is the reason why we are where we are right now.

3. WEAR YOUR FACE COVERING PROPERLY

This is an aerosol-borne disease without question. A disease which is predominantly respiratory in nature. Evidence shows that face coverings work.

However face coverings are completely ineffective if they are just warming your chin, dangling from one ear or completely missing. Face coverings must also cover your nose as well as your mouth as you produce aerosol from both of these connected orifices.

There is increasing evidence that even more effective masks might need to be used against the new and more transmissible variants but whilst we await developments in this area, we feel this just emphasises the importance of wearing face coverings effectively.

Remember, face coverings remain important even in the home environment, for example, if you have a workman coming into your home.

4. MAKE SURE YOUR BUBBLE HAS NO HOLES

Do you know what every person in your bubble is doing? Can you be sure that each one of them is wearing a mask properly, washing their hands, maintaining social distance and following all the rules?

Do you know if people in your bubble are meeting any other people?

The more interactions that each member of your bubble has with the outside world, the more connections you will have and therefore this will increase the risk of you connecting to a potentially positive case.

Everyone in your bubble should be very careful when meeting up with people outside of the bubble or even meeting people coming to the door or into the house.

If someone in the bubble gets coronavirus, then everyone in the bubble will need to self-isolate.

5. BEING JABBED DOESN'T MEAN YOU CAN RELAX

The vaccine does not make you invincible. It does give you good protection against covid, but you may still get it. Hopefully though, it will be a less serious episode of illness.

Also remember that you are not fully covered until you get your second dose.

Until you know everywhere and everyone is safe, you must still follow all local and national restrictions in place, wear face coverings, practise social distancing and maintain excellent standards of hygiene.

The same goes for catching covid previously. Although re-infections are rare, they do happen, and it is not known if a previous mild illness results in a worse case the second time round. So it is still advisable to follow all the rules.

6. JUST BECAUSE YOU CAN DOESN'T MEAN IT'S TOTALLY SAFE

Throughout this pandemic, government response has always been a balance between political and economic constraints on the one hand and scientific knowledge and medical need on the other, with the balance shifting one way or the other, and not always in the right direction. Just because some form of activity, socialising or mixing might be allowed, you might be falsely led to believe that the risks are less than they actually are.

Examples here include 'Eat Out to Help Out', 'Rule of 6' and sadly, the most recent permitted event of allowing household mixing on Christmas Day, which has undoubtedly cost many thousands of lives in the last few months or so.

The key here is to do what you need to do yourself to be safe, not do what you can do just because it is allowed, or not illegal.

7. VENTILATION IS VITAL

Even before covid, it was clear that lack of ventilation is unhealthy. It is also clear that staying indoors for prolonged periods is not always healthy. But the two combined is even worse. In winter, during our home visiting rounds, we saw too many people, especially the elderly, being stuck indoors, generally less active or staying in bed, with the heating on full blast, and with all windows shut, leading to high rates of respiratory infections and illness.

Ventilation has been shown to reduce the risk of infection from virus particles by up to 70%. This is especially important for a condition where 'viral load' is a real issue - that is, if you are infected by more virus particles, you tend to end up with more severe disease. Trying to avoid high viral load also applies if you have a household member poorly with coronavirus - good ventilation and self-isolation as much as possible will help to reduce the exposure of other household members to excessive numbers of virus particles.

The proven concept of viral load means that each precautionary measure you take can play its part in reducing the number of infectious particles you are exposed to. So, social distancing will help a bit, face coverings will help a bit, ventilation will help a bit. All the measures previously specified will help a bit. And all of it adds up to more effective measures against the virus.

And ventilation is not just about opening a window. It must also involve air movement so that there is an active flow to allow fresh air indoors. Obviously in winter time, you don't want to get a chill and then pneumonia! But you can still ventilate by opening windows for short 10-15 minute bursts throughout the day, or leave windows slightly ajar continuously so that there is always some continual air movement.

And remember to ventilate if you have visitors to your home, for example, workmen, carers or other essential keyworker visits to help support you.

8. KEEP YOURSELF HEALTHY

It is very difficult when you are dealing with a global phenomenon with changes happening all around you over which you might feel you have little or no control. Whilst this is to some extent true, there are still steps you can take to help yourself and your immediate environment.

The worst thing you can do throughout this pandemic, is to just stay at home, doing nothing much at all, and just think about the situation.

We can elaborate on keeping generally healthy in another issue of the news update when we have time, but the following is just a simple list of things that everyone can do.

Although we are still in lockdown, you can still get fresh air and exercise and some sunshine on your skin when the weather is fine. You can eat healthily and watch portion size. You can try to get to bed on time, and get enough sleep. Avoid smoking and drinking excessively. You can keep up to date and share perspectives with friends and family through electronic means, like social media, video chat or simple phone calls. You can keep your mind active and healthy with interests and hobbies which you may have forgotten about.

All of these little things will help us to keep healthy so that we don't put ourselves more at risk from this virus.

FOLLOWING THE RULES WILL HELP US GET OUT OF THIS

As before, please follow the rules on what you can and can't do.

COVID VACC QUESTIONS

We're sure you have many questions about covid vaccine. So if you need them answering, and you've not already visited our covid vaccination page, please do so now.

The covid vaccination page also provides useful progress indicators to inform patients on the current status of the programme.

We would kindly ask all patients to review the page before ringing us as the number of queries we are receiving about covid vaccine in general runs the risk of blocking urgent calls from coming in to us.

Questions answered on the page include:

We also provide links to some very useful leaflets and official FAQs on the page, including the extensive FAQ document from Joined Up Care Derbyshire.

COVID VACC GROUP 6 (MEDICAL CONDITIONS)

Group 6, by far, represents the largest group for covid vaccination in our practice population. We are absolutely sure there will be hundreds of questions, but we implore all of you to not contact us with your queries if you can help it! The risk is that our staff will simply have no time to deal with anything else.

To help you all, we have updated our covid vaccination page to provide a specific information section on group 6 eligibility.

Please visit our page to see if your question is answered.

NON-URGENT WORK AND THE VACCINATION PROGRAMME

Vaccination has been identified as one of the most important areas to focus on as a viable way out of this pandemic for everyone.

Both NHS England and Derby and Derbyshire CCG are supporting practices to suspend all non-urgent work in our efforts to deliver the vaccination programme.

Unfortunately, our days remain as busy as ever with ongoing day-to-day work, much of which remains non-urgent.

Like any other workplace, we have been subject to the same constraints with staff sick with illness or stress, self-isolating, dealing with childcare issues, as well as adhering to all necessary measures to keep patients and staff safe whilst trying to accommodate both non-covid and covid cases.

Throughout the pandemic, things clearly have not been 'business as usual', and the CCG and NHS England have been monitoring the precarious state of general practice with most practices reporting their Operational Pressures Escalation Level (Opel) as being at level 2 which is 'Amber'. This means that various types of work have already had to stop.

With the roll-out of the covid vaccination programme, something else has to give, when we are having to safely accommodate hundreds of vulnerable people through our doors, allow observation waits of 15 minutes and do this both during the week and at weekends for weeks on end. Consequently, practices will be pushed into Opel 3, which is 'Red' status. This means that non-urgent activity and reviews have to stop.

Unfortunately, despite repeated assurances and written guidance from the powers-that-be regarding stopping non-urgent activity, there has been no public messaging about this, which we believe to be vital if we are to be allowed to fully concentrate on the vaccine programme.

Notwithstanding this, we kindly ask for your patience and understanding when considering the need to contact us if you have a non-urgent problem. This is in no way diminishing the importance of your issue, but if you do have a non-urgent problem, we do ask for your consideration in deciding if your condition needs immediate response or can wait a little longer.

The more time and energy we have to be able to concentrate our efforts on vaccinating everyone who needs a covid jab, the faster we can all get back to some sort of normality, and return back to a time when we will be able to deal with anybody that needs medical help, whether urgent or non-urgent.

And please don't forget that normality does not just mean health services getting back to normal. It also means that families can get together and grandparents will be able to hug their grandchildren. It means that people can go to the pub and meet up with friends and have a drink or a meal. It means children can go back to school and see their friends in person and get back to learning as they should. It means taking holidays and trips and a host of new experiences. There is already emerging evidence from other countries that a robust vaccination programme can tame the pandemic and pave the road towards normality.

Therefore, whilst we are concentrating on efforts that will help to get the country out of this pandemic, we do urge all patients to use NHS services responsibly and to check the available resources on our website and elsewhere:

COVID VACCINE CLINICS UPDATE

We are supporting the covid vaccination programme.

We have now run several successful in-house covid vaccination clinics for our own patients, separately from the local vaccination centre in Church Farm for the neighbourhood. We thank all patients who have attended in an orderly fashion, patiently waiting their turn and complying with any observation time needed. Also we would like to thank our hardworking staff for helping out and making the clinic run effectively and smoothly.

Overall, despite vaccine delivery still being rather hit and miss, the local network of practices have made great progress in getting their vulnerable patients jabbed. The chart below shows how Ivy Grove patients are doing:

Derbyshire is in fact second only to Somerset with 92.5% of those in groups 1 to 4 having been vaccinated with their first dose. So well done everyone!

We need to remind you all that the programme is a marathon, and not a sprint, and is still ongoing, so there will be occasions when we will be closed in the afternoon, so that we can run a vaccination clinic for vulnerable patients.

During these times, our doors will be closed to casual visitors and our phone lines will be transferred through to the 111 service and our eConsult service will not be available.

Once vaccine supply is fully established, we hope to be able to close regularly one afternoon each week so that we can devote time and energy into getting more of you vaccinated.

Because very little notice is given on vaccine delivery currently, clinics have to be arranged very quickly and invites sent out promptly. Please therefore bear with us if we have to rearrange any prebooked appointments at short notice to accommodate clinics.

If you have any general questions about covid vaccination, please visit our covid vaccination page.

Thank you for supporting us in our efforts against coronavirus at this time of national crisis.

PLEASE DO NOT ABUSE OUR CONTACTS FORM

Despite prominent warnings on our contacts page about not submitting any queries of a medical nature to us via our website contact form, and despite tick boxes within the form itself confirming same, we are still finding many patients are using the website contact form to ask us about their medical conditions.

We would like to remind all patients that the contact form on the website is for non-medical matters only, for instance, letting us know a change of phone number, feedback about something on the website not working, informing us that you are a healthcare professional, passing on a compliment. It is not for asking us about your medical condition or for submitting a complaint.

Messages sent via the contact form are not monitored on a regular basis and you could risk your medical query being missed.

We have a formal channel for medical advice and consultation, and that is the eConsult service, not our website contact form.

In the future, any message of a medical nature submitted on the website contact form will receive a standard reply asking the sender to complete a full eConsult, so that we may assess the query safely in a formal environment.

Thank you for your co-operation in this matter.

RECENT FEEDBACK RECEIVED

It is with gratitude that we continue to receive heartwarming thanks from our patients during these difficult times, and we would like to share some recent messages with you from various channels.

Hi, I wanted to say a huge Thank You for today vaccination. I’ve not left the house since March 2020 so this was a big deal. The vaccine didn’t worry me , however being near others did. You all worked so hard from cleaning the chairs, checking on those that had had their vaccines and the GPs doing the vaccines themselves. Upmost respect to every single one of you. Thank you for everything . Stay well all of you. - JL x

To all the staff at Ivy Grove Surgery. While I was checking my emails, Mum received a message to book her appointment for her first Covid vaccine down at the Church Farm surgery. We did this together online, and within 3 minutes of receiving the message to book it she received another message to confirm the appointment- it took the amazingly short time of 3 minutes! My partner's father with another surgery, also had his first covid vaccination down at Ivy Grove Surgery last Saturday and he was very happy with his treatment and I cannot stress how much of a relief it is to both our families that Ivy Grove Surgery is performing covid vaccinations and how lucky we are that Mum and partner are some of the people to have them from you. Thank you. - JW

I brought my Mum for her covid vaccination on Saturday and you are to be applauded for the efficiency of the service you provided. We were in and out in less than 20 mins, including our 15 mins whilst we waited to make sure there was no adverse reaction to the treatment. We had a laugh on our return home as Mum said 'it was a lovely outing and done her a power of good'. Fingers crossed it has. Thank you for all that you are doing to get us all vaccinated. - JH

Fantastic organisation when my Mum had her 1st jab yesterday. Thank you to all the staff & volunteers who made it run smoothly. - JW

Had my vaccine Saturday morning and wanted to let you know how brilliantly efficient your set up was. Every member was staff I encountered was extremely helpful and the lady who gave me the vaccine explained everything and I have to say I didn’t feel a thing. Thanks to everyone and looking forward to my second. - DB

A big thank you today goes to the nursing team at Ivy Grove Surgery Liz from the primary care network and our Director of Public Health for Derbyshire, we have started getting vaccinations for the Housemates woo hoo! such an emotional day. Thank you - OH

Had my first jab at Ivy Grove Surgery today. Thanks to everyone for their brilliant vaccine rollout - TY

Thank you for your hard work in getting the community vaccinated, it’s much appreciated. - DG

Very proud of the NHS. Thank you Ivy Grove for all you are doing. It is very much appreciated. - LS

Thank you for the update. What a mammoth task! This vaccination programme makes you proud to be British, keep up the awesome work, thank you all. - JJ

You are all doing an amazing job thank you so much to everyone. - AC

Thanks for all you are doing. Booked my appointment for the jab today. - SG

PLEASE BE AVAILABLE TO ANSWER YOUR PHONES

Our days remain horrendously busy, dealing with anything from complex cases remotely, to reviewing selected patients face-to-face, along with the time-consuming cleaning, PPE and preparation involved, to visiting palliative care patients and also trying to fit in covid vaccination clinics to protect the population. Often we do not finish the morning's work till well after five in the afternoon. Therefore, given how pressured we are, we cannot promise any particular time for call back for your problem.

We do appreciate you may all have busy lives too, as keyworkers out and about, or at home, managing schooling, working from home, but we are often finding that patients have just called us or got into contact, and we then find that they have become uncontactable despite repeated attempts by us to reach them all day.

We will attempt to call you twice during the day before asking you to rebook an appointment with us. By doing so, we can ensure that everyone has a fair chance of consulting with us and that we can concentrate on helping as many people as possible.

MORE ON RED FLAG SYMPTOMS

We touched on this last month in terms of asking patients not to hesitate to contact if they have 'red flag' symptoms. Here we expand on this topic further.

The work of general practice is about many things, for instance, it is about long term continuous care of patients, their families, their children, grandchildren over very many years. It is also about treating the person as a whole, and not just as a particular body system or condition.

It is about knowing a little bit about everything, and not about knowing a lot about a little thing (consultant), but importantly, it's about knowing what to do and where to go for help when you don't know what to do and where to go for help!

Your doctor may refer you to hospital specialists, but GPs are still specialists in their own right, namely specialists in family medicine, in general practice.

One of the main areas of general practice is about detecting disease early, before it has a chance to take hold and so that outcomes can be changed or improved. Therefore as GPs we are always mindful when patients present with what we call 'red flag' symptoms.

A red flag symptom is a symptom that could indicate something more serious going on.

We strongly encourage all patients to start using our symptom checker which tells you if your symptom or condition carries a 'red flag' () and tells you whom you need to contact about it.

We start off with major red flags.

Given how often things like this have been on the media, we hope that by now all of you know what to do if you develop a major red flag symptom. Examples include:

Now to other red flags.

The following are some red flag symptoms that may indicate that you need to get in touch with us sooner rather than later:

Obviously the above list is not the full list of red flags and even some of the above may not always mean something serious is going on, so if you are ever unsure, please do not hesitate to get in touch and we can advise. More information on the hundreds of symptoms or conditions that you may have can be found on our symptom checker, along with details of what you can do about them.

POOR SLEEP - FOLLOW OUR TIPS

We're sure all of us have suffered with poor sleep at some point in our lives. Sleep problems are very common in general, with up to a third of the population suffering at any one time. But we have found that sleep problems have become even more of an issue during the pandemic.

Therefore in order to help our patients and also their children, we have provided some useful hints and tips along with links to official sites and leaflets that might help you to get a better night's sleep.

DR WORDLEY RETIRING AT END OF THE MONTH

If you have not already seen Dr Wordley's message to you all, following announcement of his impending retirement, we urge you to have a read.

PATIENCE AND UNDERSTANDING

Hopefully all of you can now understand what we are up to whilst we concentrate on the covid vaccination programme and kindly ask for your patience and consideration over the coming months as the pandemic continues.

Look after yourselves and keep safe.

Kind regards

Ivy Grove Surgery

Written by Dr M. Wong