Pregnant women will also be offered financial incentives to help them quit as part of a sweeping package of measures to cut smoking rates in England
One million smokers will be encouraged to swap cigarettes for vapes under a pioneering new “swap to stop” scheme designed to improve the health of the nation and cut smoking rates.
As part of the world-first national scheme, almost one in five of all smokers in England will be provided with a vape starter kit alongside behavioural support to help them quit the habit as part of a series of new measures to help the government meet its ambition of being smokefree by 2030 – reducing smoking rates to 5% or less. Local authorities will be invited to take part in the scheme later this year and will design a scheme which suits its needs, including deciding which populations to prioritise.
In a speech today, Health Minister Neil O’Brien will also announce that following the success of local schemes, pregnant women will be offered financial incentives to help them stop smoking. This will involve offering vouchers, alongside behavioural support, to all pregnant women who smoke by the end of next year.
The government will also consult on introducing mandatory cigarette pack inserts with positive messages and information to help people to quit smoking.
Additionally, there will be a crackdown on illicit vape sales as part of measures to stop children and non-smokers take up the habit – which is growing in popularity among young people.
Health Minister Neil O’Brien will say: “Up to two out of three lifelong smokers will die from smoking. Cigarettes are the only product on sale which will kill you if used correctly.
“We will offer a million smokers new help to quit. We will be funding a new national ‘swap to stop’ scheme – the first of its kind in the world. We will work with councils and others to offer a million smokers across England a free vaping starter kit.”
The new policies will deliver the UK Government’s three aims to help more adults quit smoking, stop children and non-smokers from taking up vaping, and using vaping as a tool for established adult smokers to quit.
For those who quit, the risk of heart attack is halved after one year of quitting, ultimately halving the likelihood of ending up in a hospital bed or worse.
Supporting more women to have a smokefree pregnancy will reduce the number of babies born underweight or underdeveloped with health problems requiring neonatal and ongoing care. It will also reduce the risk of miscarriage and stillbirth.
Cutting smoking rates reduces the number of smoking-related illnesses needing to be treated, in turn reducing the pressure on the NHS, helping to deliver on our priority to cut NHS waiting lists.
NHS figures for 2021 showed that 9% of 11- to 15-year-old children used e-cigarettes, up from 6% in 2018.
In recognition of the sharp increase, Minister O’Brien will launch a Call for Evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products – and explore where government can go further.
Working with enforcement agencies and learning from the government’s work with Trading Standards on illicit tobacco, £3 million of new funding will also be provided to create a specialised ‘illicit vapes enforcement squad’ to enforce the rules on vaping and tackle illicit vapes and underage sales.
As part of the measures, HMRC and Border Force will also be publishing an updated strategy this year to tackle illicit tobacco. It will lay out strategically how we continue to target, catch and punish those involved in the illicit tobacco market.
Smoking prevalence in England in 2021 was 13% – the lowest on record thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services
In 2021-22, £68 million of public health grant funded was spent on stop smoking services by local authorities and nearly 100,000 people quit with the support of a stop smoking service.
In addition, £35 million has been committed to the NHS this year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.
However, 5.4 million people in England smoke tobacco which remains the single biggest cause of preventable illness and death. Up to two out of three lifelong smokers will die from smoking and recent data shows one in four deaths from all cancers were estimated to be from smoking.
Last year an independent smoking review led by Javed Khan proposed a range of measures to help people stub out the addiction, which has informed the measures set out today.
trials in 11 areas across England to help people’s mental and physical health
GPs will issue social prescriptions such as walking, wheeling and cycling, backed by £12.7 million
schemes will include cycling and walking groups, cycle training and free bike loans
Social prescriptions, including walking, wheeling and cycling, will be offered by GPs as part of a new trial to improve mental and physical health and reduce disparities across England, the government has announced today (22 August 2022).
The government has awarded £12.7 million in multi-year funding to 11 local authority areas in England. The funding will go towards several pilot projects in each location, including:
adult cycle training
free bike loans
walking groups
Other schemes include all-ability cycling taster days where people who may not have cycled before can try to in a friendly environment, or walking and cycling mental health groups where people can connect with their communities as they get active.
The pilots must be delivered alongside improved infrastructure so people feel safe to cycle and walk.
The 11 local authority areas that will trial social prescriptions are:
Bath and North East Somerset
Bradford
Cornwall
Cumbria
Doncaster
Gateshead
Leeds
Nottingham
Plymouth
Suffolk
Staffordshire
The pilots, a commitment in the government’s Gear Change plan published in 2020, aim to evaluate the impact of cycling and walking on an individual’s health, such as reduced GP appointments and reliance on medication due to more physical activity. For the first time, transport, active travel and health officials will work together towards a whole systems approach to health improvement and tackling health disparities.
Walking and Cycling Minister, Trudy Harrison, said: ”Walking and cycling has so many benefits – from improving air quality in our communities to reducing congestion on our busiest streets.
“It also has an enormous positive impact on physical and mental health, which is why we have funded these projects which will get people across the country moving and ease the burden on our NHS.”
National Active Travel Commissioner, Chris Boardman, said: “As a nation we need healthier, cheaper and more pleasant ways to get around for everyday trips. Active Travel England’s mission is to ensure millions of people nationwide can do just that – so it’s easier to leave the car at home and to enjoy the benefits that come with it.
“Moving more will lead to a healthier nation, a reduced burden on the NHS, less cancer, heart disease and diabetes, as well as huge cost savings. This trial aims to build on existing evidence to show how bringing transport, active travel and health together can make a positive impact on communities across England.”
The pilots will be delivered between 2022 and 2025 with on-going monitoring and evaluation to support continued learning.
The project is bringing together a range of government departments and agencies including:
“The health service is in the middle of the biggest crisis it has ever faced“
The latest monthly Emergency Department (ED) performance figures published by NHS England for December 2021 show that four-hour performance at major Emergency Departments reached its lowest since records began at 61.2%, meaning nearly two in five patients were delayed by four-hours or more and nearly 1 in 4 admissions experienced a wait of at least four hours from the decision to admit them to admission.
The data also show the highest number of 12 hour waits ever recorded: 12,986 patients spent 12 hours or more from decision to admit to admission. This is a 22% increase on the previous month, November 2021, and it is 250% higher than December 2020.
Responding to the publication of NHS England quarterly and monthly performance figures, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:“The situation on the ground is extremely bleak. Staff are overwhelmed and burned out; it is increasingly challenging to provide timely and safe patient care.”
Latest Quarterly performance figures published by NHS England show that in 2021-2022 there were a total of 43,218 12-hour delays which is more than all the 12-hour delays over the previous ten years put together (39,608).
The data does not paint the full picture as NHS England record 12-hour waits from decision to admit. Our Winter Flow project, which started at the beginning of October 2021, has so far recorded 71,965 12-hour waits from time of arrival.
It is critical that NHS England commit to reporting 12-hour data from time of arrival and implement the Clinical Review of Standards.
Dr Henderson said:“The health service is in the middle of the biggest crisis it has ever faced, and staff are working harder than ever before with fewer staff and fewer beds.
“When the health service is overwhelmed, it does not cease to function, it is the standards and quality of care that fall. The figures published today show the extent to which these standards have fallen already.
“Performance metrics are intended to hold clinical services to account. They are meant to identify areas in which services are failing with the aim of improving them quickly and effectively.
“The consistent and continuous decline of urgent and emergency care performance, standards, patient experience and patient safety show how this intended function is now entirely lost. With each publication around performance, we commentate with shock and dismay at the latest decline, but our comments are, more often than not, met with inaction or short-term fixes. There needs to be acknowledgment that there is a major public health crisis in emergency care.
“It is the core ability and function of the health and social care service to deliver high-quality and effective care to the acutely ill or injured that is at risk.
“We must now see a vision for recovery and a vision for the health service that includes a vital transformation of the urgent and emergency care system. There must be a plan to implement a framework that is centred around patient care, that drives action and improvement.
“The current framework is simply documenting the health system’s failure to deliver a quality service, and the failure of this framework leaves urgent and emergency care in a performance vacuum.
“We need a decision about either a phased implementation of the findings of the Clinical Review of Standards or an honest discussion about how we performance manage urgent and emergency care differently.
“The current challenges facing the health and social care service are the result of years of stagnation and decline, they are made worse by, but are not just a consequence of, the pandemic. Recognising this is vital to any step towards transformation.
“It is time we saw bolder political willingness to engage on these critical issues. Without action, performance will continue to decline, and this would be a disservice to patients and staff.”
New advert shows Chief Medical Officer Professor Chris Whitty urging public to get COVID-19 booster jab
Part of new multimedia marketing blitz as booster rollout accelerates to offer all adults in England a jab by end of the year
This comes as new milestone hit with 24 million boosters given in UK and 75% of over 50s boosted
Data shows booster is needed to protect against the Omicron variant
Chief Medical Officer for England Professor Chris Whitty is calling on the public to get a booster vaccination, in a nationwide advertising campaign launched yesterday (Tuesday 14 December) to further galvanise the booster programme.
This comes as a total of 24 million boosters and third doses have now been administered in the UK.
75% of over 50 year-olds across the UK have had their booster or third dose and over 1 million people have booked a booster vaccination appointment since the National Booking Service opened yesterday to people aged over 30 in England. The booking service will expand to all adults in England tomorrow.
The NHS in England experienced its busiest Monday ever for vaccinations this week since the rollout began in December last year when 418,000 boosters were delivered, with 185,000 of these delivered by community pharmacies.
The latest preliminary data has shown vaccine efficacy against symptomatic infection is substantially reduced against Omicron with just two doses, but a booster pushes protection back up to over 70%, showing how vital the top up jab is to bolster immunity.
In the advert, Professor Whitty says: “There is a new variant of COVID-19 – Omicron – which is highly infectious and spreading fast.
“Every adult in the country needs to get a COVID-19 booster vaccine.
“Boosters give you the best possible protection against the virus and should significantly reduce your risk of serious illness and hospitalisation.
“Get your COVID-19 booster vaccine to strengthen your protection. Please, get boosted now.”
Health and Social Care Secretary, Sajid Javid, said: “We know a booster jab increases protection against the Omicron variant and in our race against the virus it’s crucial everyone gets their top-up jab.
“Our heroic NHS staff and volunteers are working around the clock to speed up our vaccination programme, helping millions of people to get boosted now – so play your part, roll up your sleeves and get protected.”
Data suggests Omicron is extremely transmissible and is rapidly becoming the dominant variant as cases double every 2 to 3 days. The Chief Medical Officer is encouraging “every adult in the country” to get a booster vaccine and strengthen their protection.
The UK has the fastest booster rollout in Europe, with over 23 million people having received their boost so far, but to stay ahead in this race against the virus the booster programme is opening up to give every adult the chance to get their booster before the New Year.
To boost the booster programme the UK government and the NHS are:
Opening new vaccination sites across the country, including pop up and mobile sites
Increasing opening times of vaccination sites to 7 days a week
Asking GPs and pharmacies to do more vaccinations
Bringing in 750 Armed Forces Personnel and 41 military planners in every region to help coordinate the national effort
The latest Emergency Department performance figures for September 2021 published today by NHS England show the highest number of 12-hour stays on record, the highest number of four-hour stays on record, and the worst four-hour performance ever recorded.
The latest figures were published on the day the UK Government set out it’s Plan to improve access for NHS patients and support GPs.
The data show in September 2021 there were 1,392,542 attendances to Type 1 Emergency Departments in England.
Four-hour performance has deteriorated for the sixth consecutive month, once again reaching a record low. Just 64% of patients in Type 1 Emergency Departments were admitted, transferred or discharged within four-hours.
A record breaking 5,025 patients stayed in an Emergency Department for 12-hours or more from decision to admit to admission. This is an 80% increase on the previous month, August 2021, and it is the highest number of 12-hour stays since records began and is almost a third higher than the previous highest, recorded in January 2021. The number of 12-hour stays from time of arrival is not published but is likely to be significantly higher.
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “This data is bleak and is a stark warning of the crisis that we are heading towards this winter.
“Dangerous crowding has returned to Emergency Departments, exit block is preventing a flow of patients through the hospital, and there have been widespread reports of ambulances queuing outside hospitals facing long handover delays.
“For patients, this means long and potentially frustrating waiting times in the Emergency Department. For staff it is incredibly challenging, as they do all they can to continue to deliver care quickly amid rising attendances and pressures.
“At the same time the health service continues to manage covid as cases have been rising steeply, with the NHS now treating around 14 times as many patients as the same time last year.
“Trusts also continue to deliver elective care but there is a real threat that in the coming months this may once again have to be paused to manage pressures on urgent and emergency care and the rising number of covid cases.
“The winter presents a significant challenge for the health service; staff are increasingly worried about the NHS’ ability to cope. The Government need to recognise the potential crisis and support the health and care service as it tackles the challenges ahead.
“NHS England’s Urgent and Emergency Care Recovery 10 Point Action Plan is a blueprint on how to manage these pressures in the short and medium term. Trusts must do all they can to follow this guidance to mitigate pressures across the system and prevent further deterioration in performance.
“But the underlying cause of all of the problems facing the NHS is a decade of underfunding. The health service has for a long time struggled to meet the demand of the population. It is short on staff across the board; capacity has not risen in line with demand. Existing staff are exhausted, with many looking to leave after having to shoulder an ever-increasing workload.
“So far promises to increase the workforce have fallen short. The forthcoming spending review is an opportunity for the government to signal it’s intent to boost staffing with a long-term workforce plan and rescue the NHS in the long run.”
Meanwhile the NHS, working closely with the Department of Health and Social Care, has today published a blueprint for improving access to GP appointments for patients alongside supporting GPs and their teams in England.
Surgeries will be provided with additional funding to boost their capacity to increase the proportion of appointments delivered face to face, as part of a major drive to support general practice and level up performance, including additional efforts to tackle abuse against staff.
The measures, including a £250 million winter access fund from NHS England, will enable GP practices to improve availability so that patients who need care can get it, often on the same day if needed. The investment will fund locums and support from other health professionals such as physiotherapists and podiatrists, with a focus on increasing capacity to boost urgent same-day care. This is in addition to £270 million invested over the previous 11 months to expand capacity and support GPs.
Amanda Pritchard, chief executive of the NHS, said: “Improving access to high quality general practice is essential for our patients and for the rest of the NHS too.
“It is a personal priority and today NHS England is taking both urgent and longer term action to back GPs and their teams with additional investment and support.”
Secretary of State for Health and Social Care Sajid Javid said: “I am determined to ensure patients can see their GP in the way they want, no matter where they live. I also want to thank GPs and their teams for their enormous efforts in the most challenging times in living memory.
“Our new plan provides general practice teams with investment and targeted support. This will tackle underperformance, taking pressure off staff so they can spend more time with patients and increase the number of face-to-face appointments.
“Alongside this we are setting out more measures to tackle abuse and harassment so staff at GP surgeries who work so tirelessly to care for patients can do so without having to fear for their safety.”
The NHS England document makes clear that every GP practice must seek patients’ input and respect preferences for face to face care unless there are good clinical reasons to the contrary.
The extra investment will help to increase the number of appointments delivered, while local health systems will be free to determine how best to tackle particular challenges to access and provision of care in their own community, which could include putting in place additional resource for walk-in consultations.
Local plans will need to deliver these improvements in access, with practices that do not provide appropriate levels of face to face care not able to access the additional funding, and instead offered support to improve.
Under the plan, the NHS will also support upgrades to telephone systems, ensuring that more patients can quickly and easily speak to general practice staff, and help the public avoid long waits when contacting a surgery by phone.
The government will also reduce administrative burdens on GPs by reforming who can provide medical evidence and certificates such as FIT notes and DVLA checks – freeing up time for more appointments.
UKHSA will complete its review of infection prevention and control (IPC) guidance in general practice and set out practical steps on IPC measures in GP settings which could increase the number of patients that can be seen.
As part of this package, the NHS will increase its oversight of practices with the most acute issues in relation to access, and GP appointment data will be published at practice level by spring next year. This will enhance transparency and accountability, as monthly data is currently only published by clinical commissioning group.
In addition, patients will get the opportunity to rate their practice’s performance, via text message, based on their most recent experience of accessing support. This survey, which has been previously agreed with the profession, is being piloted in around 60 practices and will be rolled out next year.
Together with the government and Academy of Medical Royal Colleges, the NHS will also develop a zero-tolerance campaign on abuse of NHS staff, including GP teams.
General practice teams have delivered more than 300 million appointments over the last year as well as delivering the vast majority of Covid vaccinations, saving lives and protecting millions of people against the virus at speed.
Health Minister Maria Caulfield said: “As a nurse on the frontline during the pandemic I know how hard GPs and their teams have worked, while recognising how badly so many people want to see their GPs in person.
“This plan will give our dedicated general practices the support needed to increase capacity, boosting the number of appointments for patients to see and speak to their GP practice.
“I look forward to continuing to work with the sector to ensure patients can get the care they need.”
Patients will also be able to see different types of clinicians in general practice, who can best meet their needs and conditions, including pharmacists, paramedics, advanced nurse practitioners and nursing associates.
NHS England will also work with the government to consider how far and fast the role of pharmacists can be increased in the supply of medication, as part of relieving workload on GPs.
Government’s ‘rescue package’ for GPs is flawed and patient care will suffer as result, warns BMA
“It’s truly frightening that we have a government so ignorant to the needs of such a core part of the NHS”
Responding to the publication by the Department of Health and NHS England and NHS Improvement today, outlining their plans to improve access for NHS patients and support for GPs, BMA GP committee chair Dr Richard Vautrey said: “After weeks of promising an ‘emergency package’ to rescue general practice, we’re hugely dismayed that whilst additional funding has been promised, the package as a whole offers very little and shows a Government completely out of touch with the scale of the crisis on the ground.
“GPs and their teams will now be facing the worst winter for decades, and as a result, patients’ care will suffer. Appointments will be harder to book, waiting times will get longer, more of the profession could leave and GPs will struggle to cope.
“It is also disappointing to see that there is no end in sight to the preoccupation with face-to-face appointments; we need a more intelligent conversation about the variety of appointments and care that are available to patients to meet their needs.
“While in-person consultations are a key feature of general practice and absolutely necessary for some patients and certain conditions, the pandemic has proven that in many other cases, phone or video appointments are entirely appropriate and appreciated by patients, and a crude focus on percentages or targets is completely unhelpful.
“Throughout our discussions with ministers and NHS England in recent weeks, the BMA has been clear that without a concerted effort to reduce bureaucracy, admin and red tape in practices, patient access and care was at risk.
“Unfortunately, today’s offer merely tinkers around the edges, and will not reduce the unnecessary burden practices carry and therefore free up any more time for doctors to see more patients. We need an end to target-driven, payment-by-results, care and allow practices to look after patients in a way that is flexible and right for the person in front of them and the Government have missed an opportunity to tackle this.
“Reducing the administrative burden on GPs by reforming who can provide medical evidence and certificates such as Fit notes and DVLA checks, won’t happen for some time and is a mere drop in the ocean as what is needed is urgent action now to free up sufficient time for more appointments.
“While the additional £250m is welcome, it must be easy for practices to access rapidly and they must not be forced to have to produce reams of plans or try to meet unattainable targets to get it – which has often happened in the past.
“We had four simple asks – and only one appears to have been fully answered. Increased sentencing for assaulting healthcare workers is something we asked for, but meaningless if the same Government refuses to address the crisis fuelling such abuse. The Secretary of State has started to address a second, by talking more positively about general practice but he needs to do much more to publicly support the profession when we are under such pressure and facing a torrent of abuse on a daily basis.
“These proposals will only confirm the profession’s belief that ministers and NHS England fail to understand the dire state of general practice – or that they, not hardworking GPs, are to blame.
“It’s truly frightening that we have a government so ignorant to the needs of such a core part of the NHS. GPs want to improve the care we offer to our patients, but today’s offer will not enable us to do that as we had hoped.
“GPs across England will be truly horrified that this is being presented as a lifeline to general practice, when in reality it could sink the ship all together. There can be no doubt that this lack of action at such a critical time will force many GPs to hang up their stethoscopes and leave the profession for the last time.”
Government urges up to 1.5 million people in England who face the highest risk of being hospitalised by the virus to shield themselves and stay at home
People with specific underlying health conditions, including some being treated for cancer, will be contacted by the NHS this week
Plans also unveiled to deliver groceries and medicines for those most at risk from the virus where needed
Up to 1.5 million people in England identified by the NHS as being at higher risk of severe illness if they contract coronavirus should stay at home to protect themselves, the Government urged today.
They will receive communication shortly with detailed advice on behalf of their GP practice or specialist on how best to protect themselves.
A raft of new measures, including a helpline for the most in need of support, have been set out for those considered to be extremely vulnerable due to their medical conditions, so people know exactly how to care for themselves and others in the coming months.
It was also announced that a new Local Support System will make sure those individuals self-isolating at home and who are without a support network of friends and family will receive basic groceries. Community pharmacies will support those who need help getting their medicines delivered.
The Government is working with a partnership of the groceries industry, local government, local resilience and emergency partners, and voluntary groups, to ensure that essential items can start to be delivered as soon as possible to those who need it. The people identified as the most vulnerable in their communities will be contacted directly – including in person where necessary – as a priority.
Members of the armed forces, already in local communities helping Local Resilience Forums and local councils on their coronavirus response plans, will support this effort and are at the heart of local planning in response to this crisis.
Communities Secretary Rt Hon Robert Jenrick MP said: “Public safety and making sure that those most at risk from the virus continue to get the support they need throughout this period is the Government’s top priority. People should stay at home, protect our NHS and save lives.
“This will be an especially worrying time for those with serious underlying health conditions and that is why we are urgently acting to ensure extremely vulnerable individuals are taking extra steps to shield themselves, and that the essential items they need are supplied to them.
“We will ensure that vulnerable and older people in our society are left in no doubt of their importance to us and our determination to protect them as best we can. More people will be required to be by themselves at home. While they are on their own, let’s guarantee that they are never alone.”
Up to 1.5 million people in England currently live with conditions, or are taking medication or receiving treatment, which health experts have identified puts them at a much greater risk of developing serious complications if they get the virus, which may mean they need hospital treatment.
This includes, for example, those who have received organ transplants, are living with severe respiratory conditions such as cystic fibrosis and severe chronic bronchitis (COPD) or specific cancers like of the blood or bone marrow.
And some – though not all – of those receiving certain types of drug treatments including ones which suppress the immune system – leaving the body less able to fight off the virus.
People identified as belonging to one or more of the at-risk groups will be contacted by their GP practice, specialist or both strongly advising them to stay at home for a period of at least 12 weeks.
In the first instance they will receive a letter this week and, where mobile number is known, the NHS will also send frequent text messages shortly to those in this group, to reach the most at risk as quickly as possible with advice.
These communications will set out to reassure them that their ongoing medical needs will be met by the NHS, and contain advice and guidance on how to manage their condition while self-isolating, including getting prescriptions delivered and accessing support for daily living.
For the individuals most at risk of the illness, these actions will save lives.
Health and Social Care Secretary Matt Hancock said: “We are working incredibly hard, day and night, to protect the nation’s public health whilst supporting our NHS so it can continue to look after patients in need of care.
“It is vital that we do everything we can to protect ourselves, our families and our friends from being impacted by the virus. But for those who are at the highest risk in our society, we have to do even more to ensure they’re kept safe.
“Whether it’s going shopping for a neighbour in need, or keeping inside if you know you’re at risk, we all have a part to play in protecting the welfare of those who are most vulnerable.”
Dr Paul Johnstone, Director at Public Health England, said: “The NHS are contacting the people who are most vulnerable to developing a very serious illness as a result of COVID-19 with specific advice to stay at home for at least 12 weeks.
“If you receive a letter it is vitally important that you act on it for your own protection, don’t attend any gatherings of friends or families and don’t go out for shopping, leisure or travel.
“Those of us who are less at risk can play our part in protecting other people by following the government’s advice on social distancing and volunteering to give extra support to vulnerable people who are staying at home.
The guidance for people at the highest risk is:
Strictly avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough;
Do not leave your house for at least 12 weeks starting on Monday 22 March.
Do not attend any gatherings. This includes gatherings of friends and families in private spaces e.g. family homes, weddings, parties and religious services.
Do not go out for shopping, leisure or travel and, when arranging food or medication deliveries, these should be left at the door to minimise contact.
Keep in touch using remote technology such as phone, internet, and social media.
Do use telephone or online services to contact your GP practice or other essential services as and when you need.
NB: This information affects the NHS England area – expect similar advice from NHS Scotland soon.
