Dr Katherine Henderson, President of the Royal College of Emergency Medicine has stated that it is absolutely essential that patients and visitors in Emergency Departments continue to protect themselves and others with face masks, hand washing and social distancing.
Dr Katherine Henderson said: “While restrictions have been eased, it is absolutely essential that we continue to keep everyone safe in hospital settings and in Emergency Departments. Patients and visitors must therefore expect to wear a mask and maintain social distancing.
“Emergency Departments regularly see vulnerable patients. We must do all we can to keep those patients safe, but also to ensure that these patients feel safe coming to the hospital and the Emergency Department if, and when, they need help.
“We ask patients and visitors to kindly respect and co-operate with this guidance and help to keep everyone safe. Staff will not tolerate any abuse whatsoever. They absolutely do not deserve it, but it is a sad reality that we are already hearing and seeing abusive behaviour towards staff. It is clear these measures will help protect the most vulnerable patients, so it is right that all patients and visitors follow them.
“Staff will request all patients and visitors to put a mask on when in an Emergency Department and they will not be engaging in any debate on the guidance.
“It is a matter of public health and infection prevention control to keep all our patients safe.”
Now that Covid-19 restrictions are easing, you may be thinking about re-starting services and face-to-face volunteering activities. Lateral Flow Devices (LFDs) are one of the measures you can put in place to help you resume services safely and with confidence (writes Volunteer Edinburgh Chief Officer PAUL WILSON).
Volunteer Edinburgh is a “distribution centre” for LFDs for small or local voluntary organisations or community groups.
If you would like some testing kits to distribute to your staff, volunteers or service users these are available for collection from the Volunteer Edinburgh office at 222 Leith Walk between 10am and 4pm, Monday to Friday.
While we are not operating an appointment system for collection it would be much appreciated if you could call us on 0131 225 0630 to let us know roughly what time you will be coming: as we only have limited staff in the office this will ensure that someone is available to help you when you arrive.
For information on how to use the LFDs please see the Scottish Government guidance HERE and for information on testing, vaccinations and self-isolation support please click HERE.
Frontline NHS and social care staff can attend work rather than self-isolate with testing mitigations in exceptional circumstances under updated guidance announced this morning.
From today (Monday 19 July), double vaccinated frontline NHS and social care staff in England who have been told to self-isolate will be permitted to attend work in exceptional circumstances and replaced by testing mitigations.
This will include staff who have been contacted as a close contact of a case of COVID-19 by NHS Test and Trace, or advised to self-isolate by the NHS Covid-19 app.
This measure is being introduced to alleviate pressure on NHS and social care services and will be contingent on staff members only working after having a negative PCR test and also taking daily negative lateral flow tests for a minimum of seven days, and up to 10 days or completion of the identified self-isolation period.
This measure is being introduced to alleviate pressure on NHS and social care services and will be contingent on staff members only working after having a negative PCR test and daily negative lateral flow tests.
The government is clear the change applies only to frontline NHS and social care staff where their absence may lead to a significant risk of harm.
The decision to allow NHS and social care staff to attend work after being told to self-isolate should be made on a case-by-case basis, and only after a risk assessment by the organisation’s management.
This must be authorised by the organisation’s local Director of Infection Prevention and Control, the lead professional for health protection, or the Director of Public Health relevant to the organisation.
Health Secretary Sajid Javid said: “As we learn to live with this virus, it’s important that we ensure frontline staff can keep providing the best possible care and support to people up and down the country.
“The government has backed healthcare services at every turn through this global pandemic and these new rules will fortify our collective defences against this awful virus, by allowing fully vaccinated frontline NHS and social care staff to continue to work when needed.”
Careful consideration should be given by local NHS and social care organisations to the risk of onward transmission compared to the risk to delivery of critical services.
Staff who are permitted to attend work will remain under a legal duty to self-isolate as a close contact when not at work, but will be considered to have a ‘reasonable excuse’ under the Self-Isolation regulations to leave self-isolation to attend work where their absence could result in harm. They will continue to receive self-isolation reminders.
UK Health Security Agency Chief Executive, Jenny Harries, said: “With the number of cases continuing to rise, it is imperative that we do everything we can to manage this virus and support our NHS and social care services under the strain of increased demand and sustained pressure.
“We have provided specific guidance to NHS and social care settings for circumstances where there is a significant risk to health or safety resulting from staff absence or a critical service cannot run.
“This measure only applies to double vaccinated staff, who will only be able to attend work after testing negative on PCR and daily lateral flow tests, and following a risk assessment and the supervision of the health service.”
In order to mitigate the increased risk associated with attending work, the following mitigations must be implemented:
The staff member should be fully vaccinated, defined as having received both doses of an MHRA approved vaccination, with 14 days having elapsed since the final dose.
The staff member should undertake a PCR test and should self-isolate until they receive the result. They should only attend work if this result is negative.
They should undertake daily LFD tests prior to starting work each day. Test results should be reported to NHS Test and Trace via the web portal and to their duty manager. Any staff member who has a positive LFD test during this period should not attend work and should arrange a PCR test as soon as possible.
If the staff member develops any COVID symptoms, they should stay at home and immediately arrange a PCR test.
Staff working during this 10-day period should comply with all relevant infection control precautions and PPE should be properly worn throughout the day. Any breaches should be reported immediately to their line manager.
The staff member should not work with clinically extremely vulnerable patients or residents, as determined by the organisation.
Existing guidance will be updated by Public Health England today (Monday 19 July), and shared with NHS trusts and relevant social care organisations across England.
These changes apply in England only. The Scottish Government will announce any changes to exisiting arrangements, if necessary, in due course.
Free seasonal flu vaccine to be made available for over 35 million people this year
Millions more people could benefit from a free flu vaccine this year, as the Health and Social Care Secretary Sajid Javid announces the most comprehensive flu vaccination programme in UK history today
School programme expanded to provide flu vaccine to all secondary school pupils up to Year 11
Expanded programme follows record 19 million seasonal flu jabs administered in winter 2020
From September 2021, providers will offer the flu vaccine to over 35 million people during the upcoming winter season, including all secondary school students up to Year 11 for the first time. This builds on the success of last year’s expanded flu programme, which saw a record number of people get their jab.
Last year, 4 in 5 (80.9%) people aged 65 and over in England received their flu vaccine – exceeding the World Health Organization uptake ambition of 75%.
Working with the NHS, the government is preparing to deliver the expanded flu programme alongside any booster programme for COVID-19 vaccines as part of wider autumn and winter planning, which centres around protecting as many lives as possible.
During the 2021/22 season, which starts in September, the flu jab will be available to:
all children aged two and three on 31 August 2021
all children in primary school and all children in school Years 7 to 11 in secondary school
those aged six months to under 50 years in clinical risk groups
pregnant women
those aged 50 years and over
unpaid carers
close contacts of immunocompromised individuals
frontline health and adult social care staff
Health and Social Care Secretary, Sajid Javid, said: Flu can be a serious illness and we want to build a wall of protection by immunising a record number of people.
“With the nation getting closer to normal life, we must learn to live with COVID-19 alongside other viruses and we’re offering the free flu jab to millions more people to help keep them safe this winter.
“The phenomenal scale of the COVID-19 vaccination programme is a clear demonstration of the positive impact vaccination can make and I encourage all those eligible to get their flu jab when called forward.”
The enlarged flu drive will build on last year’s expanded flu programme, where flu vaccinations opened up to 50 to 64-year-olds and year 7 pupils for the first time, with the aim of offering protection to as many eligible people as possible.
For frontline healthcare workers and two and three-year olds, the highest ever recorded levels of flu vaccine uptake were also achieved last year. This year, all frontline health and social care workers will be offered the flu vaccination again to ensure they, and the people they care for, are protected.
Eligible groups are urged to get their free vaccine every year and to protect themselves and the most vulnerable people in society ahead of the winter.
As a result of non-pharmaceutical interventions in place for COVID-19 – such as mask-wearing, physical and social distancing, and restricted international travel – flu levels were lower than expected across the world in 2020/21.
It is possible there will be higher levels of flu this winter, with more of the population susceptible given the low levels last season. The flu vaccine offers the best available protection against the virus and the public can reduce the spread of flu and other winter bugs by regularly washing hands, throwing away used tissues and practising good hygiene.
Alongside this flu drive, the government is preparing for a booster programme of COVID-19 vaccines and the Joint Committee on Vaccination (JCVI) and Immunisation has published interim advice on who would be prioritised for a possible third vaccine from September 2021.
The booster programme – which would be designed to ensure millions of people most vulnerable to COVID-19 continue to have the protection they need ahead of the winter and against new variants – will be informed by the JCVI’s final advice expected later this summer based on the very latest scientific data.
The Department of Health and Social Care, NHS England and Improvement, and Public Health England have today issued the 2021/22 annual flu letter to providers, setting out plans for this year’s expanded programme. This blueprint will ensure GP practices, pharmacies and school-based providers are mobilised to begin administering flu vaccines from September.
Dr Yvonne Doyle, Medical Director at Public Health England, said: “The flu vaccine is safe, effective and protects millions of people each year from what can be a devastating illness.
“Last winter, flu activity was extremely low, but this is no reason for complacency as it means less people have built up a defence against the virus. Combined with the likelihood that COVID-19 will still be circulating, this makes the coming flu season highly unpredictable.
“We will be preparing for a challenging winter by expanding our world-leading flu vaccination programme to over 35 million people, saving more lives and limiting the impact on the NHS and social care.”
Dr Nikita Kanani, NHS medical director for primary care, said: “NHS staff across England vaccinated record numbers of people against flu last year – a potentially fatal illness – and they continue to pull out all the stops to deliver the biggest and most successful NHS Covid-19 vaccination programme in health history, protecting their patients and communities.
“Getting your free flu vaccine if you are eligible as well as keeping up good habits like regularly washing your hands could help save your life, so please do come forward when you are invited to give you and your loved ones vital protection this winter.”
The childhood flu programme aims to protect children and contain the spread of the virus to babies and vulnerable adults they may be in contact with. The nasal spray vaccine is offered to 2 and 3-year-olds and children in primary school and Year 7 and, for the first time this year, secondary school aged children up to Year 11.
Vital equipment on it’s way to fight Covid-19 crisis in Malawi, Rwanda and Zambia
A grant of more than £270,000 from the Scottish Government’s International Development Fund will fund the supply of 300 items of vital equipment to treat Covid-19 patients in Africa.
The funding will allow Kids Operating Room, a Scottish-based global health charity, to distribute 100 oxygen concentrators each to Malawi, Rwanda, and Zambia.
Covid-19 cases in Malawi, Rwanda and Zambia are rising quickly, with the health system in Zambia especially under severe stress.
One of the biggest impacts of the rise in Covid-19 cases is a shortage of oxygen, and oxygen concentrators are easy to use, are suitable for patients of all ages, and can be used throughout the health service.
External Affairs Secretary Angus Robertson said: “The Covid situation in Malawi, Rwanda and Zambia has become very serious, very quickly, and we know that the pressure on health services are putting great stress on their infrastructure, especially in relation to the delivery of oxygen to patients.
“This funding for oxygen concentrators will go some way to help ease the current stress on the health services in our three African partner countries, and we are delighted to work with Kids Operating Room to make sure this vital equipment is put to use as soon as possible.
“Scotland remains fully committed to playing our part in tackling shared global challenges, and we are committed to increase the International Development Fund (IDF) by 50% to £15 million.
“As the global pandemic continues, we firmly believe this is not the time to turn our back on the poorest and those in dire need – instead, this is precisely the moment when we should be living up to our core values.”
David Cunningham, the chief executive officer of Kids Operating Room, said: “Our model is to listen to doctors, then give them what they need – right now, the message is coming back loud and clear that what they need is access to more oxygen to fight Covid-19.
“Oxygen concentrators are key pieces of equipment that are needed to meet the region’s critical oxygen shortage. They are suitable for all ages and durable for years to come post-Covid, making them incredibly essential to support the health services in the long-term.”
Kids Operating Room is a Scottish global health charity with bases in Edinburgh, Dundee and Nairobi. It works directly with local surgeons and their teams across Africa and South America to transform hospital spaces into dedicated operating rooms for children’s surgery.
Oxygen concentrators provide a sustainable and cost-effective source of medical oxygen – they draw air from the environment and then concentrate that room oxygen to therapeutic levels for delivery to patients.
The charity will coordinate the distribution of the oxygen equipment. They will arrange for delivery to doctors in Lusaka, Lilongwe and Kigali, and have the equipment distributed to the most in-demand hospitals.
Health Secretary Humza Yousaf has visited a drop-in vaccination clinic in Arbroath as the national programme nears completion of first doses for all adults who attended their scheduled appointments on Sunday.
The clinic in Arbroath is one of many additional walk-in and pop-up facilities operating across the mainland to encourage people to get Jagged in July and Mr Yousaf urged anyone who is yet to take up their offer of a vaccine for whatever reason to come forward now.
No appointment is necessary at drop-in clinics and people can attend whether they are due a first dose or second dose, if eight weeks have passed. Anyone who wishes to book an appointment can do so at NHS Inform.
Mr Yousaf said: “I am pleased to see people making use of the vaccination clinic in Arbroath and urge others to do the same at their local drop-in venues if they haven’t yet come forward to be vaccinated.
“Getting vaccinated has never been easier. Simply head to a drop-in or pop-up clinic – the most up-to-date details of clinics near you can be found on your local NHS board’s social media posts or book an appointment online in a location which suits.
“The vaccination programme is working – evidence shows vaccination is weakening the link between case numbers and severe acute illness. However, case numbers are still high and vaccination continues to be the best way to protect yourself and those around you.
“We are currently working through the final group on the JCVI priority list – those aged between 18 and 29 – and we know that the extra drop-in clinics being operated by mainland health boards until Sunday make it easier for them to fit getting vaccinated into their busy lives. Walk-ins will still be available after this week but now is the time to take advantage of all the additional facilities on offer.
“I want to thank all those involved in setting up these clinics and of course, everyone involved in the national vaccination programme. It has been a huge success and without doubt, represents our best way out of the pandemic.”
NHS Tayside Director of Public Health Dr Emma Fletcher said: “Drop-in vaccination clinics are running at venues right across Tayside to make it as easy as possible for people to get vaccinated. No appointment is necessary and anyone over 18 can drop-in.
“So far, uptake of vaccinations in Tayside has been very good. We have delivered over 532,500 vaccines in Tayside with 300,000 people, 86% of the adult population, having one dose and around 232,500 people, 66%, having had both doses but we need that uptake to be higher to stop the spread of the virus.
“We know that getting both doses of the vaccine offers maximum protection against the virus and we are particularly encouraging people aged 18-29 to come forward as early as they can. So if you have not yet had your first jab, or you are longer than eight weeks from your first jab and are due your second jab, come along to your nearest clinic and we will get you vaccinated.”
The Prime Minister will host a press conference this afternoon (Monday 12th July) to confirm whether England can move to step 4 of the Roadmap.
Step 4 is expected to begin next Monday – so-called ‘Freedom Day’ (19th July) – if the UK government’s “four tests” for easing Covid restrictions in England have been met.
The Health and Social Care Secretary will announce the plans to parliament.
England’s four tests are:
The vaccine deployment programme continues successfully
Evidence shows vaccines are sufficiently effective in reducing hospitalisations and deaths in those vaccinated
Infection rates do not risk a surge in hospitalisations which would put unsustainable pressure on the NHS
Our assessment of the risks is not fundamentally changed by new Variants of Concern
The Prime Minister is expected to urge the public to remain vigilant and exercise caution, praising the efforts of the country for the progress made so far while warning that the pandemic is not over and that caution will be key in the coming weeks.
The latest data will be presented, with current modelling suggesting that Covid cases will continue to rise as restrictions are eased. Hospitalisations, serious illness and deaths will also continue, albeit at a much lower level than before the vaccination programme.
As of 10th July, a total of 80.3 million vaccine doses have been administered in the UK, with 45.7 million adults receiving a first dose (86.9%) and 34.5 million adults receiving both doses (65.6%).
The move to step 4 was delayed by up to four weeks so every adult could be offered a vaccine. 6.8 million first and second doses have already been administered in England during the delay so far.
The delay has also moved the probable end of restrictions to a point closer to the school summer holidays in England, when transmission is expected to be lower. Reopening at a point later in the year may increase pressure on the NHS because of winter illnesses such as flu
Analysis from Public Health England (PHE) and the University of Cambridge suggests that vaccines have so far prevented an estimated 8.5 million infections and 30,000 deaths in England alone.
Wherever you live, it is vital that people keep coming forward to get both jabs when called, with data from PHE showing COVID-19 vaccines are highly effective against hospitalisation from the Delta variant.
The analysis suggests the Pfizer-BioNTech vaccine is 96% effective and the Oxford-AstraZeneca vaccine is 92% effective against hospitalisation after two doses.
The vaccination rollout will continue to accelerate by bringing forward second doses for under 40s to eight weeks – meaning the entire population will benefit from maximum protection more quickly.
Prime Minister Boris Johnson said: “We are tantalisingly close to the final milestone in our roadmap out of lockdown, but the plan to restore our freedoms must come with a warning.
“While the phenomenal vaccine rollout has offered every adult some protection against the virus, and the crucial link between cases, hospitalisations and deaths is weakened, the global pandemic is not over yet.
“Cases will rise as we unlock, so as we confirm our plans today, our message will be clear. Caution is absolutely vital, and we must all take responsibility so we don’t undo our progress, ensuring we continue to protect our NHS.”
The Scottish Cabinet will meet tomorrow to discuss the latest situation in Scotland and First Minister Nicola Sturgeon will update parliament on our next steps in the afternoon.
Those used in the UK as effective at preventing symptomatic disease in the majority of people with underlying health conditions as the rest of the population
Within these clinical risk groups, there will be people with more severe forms of illness – particularly in the immunosuppressed group – who may not respond as well to the vaccines, and we recommend they seek advice from their specialists.
The study found:
overall vaccine effectiveness against symptomatic disease in risk groups is approximately 60% after one dose of either AstraZeneca or Pfizer-BioNTech, with little variation by age
after 2 doses, vaccine effectiveness is 81% with AstraZeneca in people in risk groups aged 16 to 64. No data is available for Pfizer-BioNTech
in people in risk groups aged 65 and over, vaccine effectiveness with Pfizer-BioNTech is 89% and 80% with AstraZeneca
for those who are immunosuppressed, vaccine effectiveness after a second dose is 74%, with similar protection to those who are not in a risk group. This rises from 4% after a first dose
Although age is the greatest risk factor for adverse outcomes following coronavirus (COVID-19) infection, certain health conditions also increase the risk of severe disease.
Diabetes, severe asthma, chronic heart disease, chronic kidney disease, chronic liver disease, neurological disease, and diseases or therapies that weaken the immune system – such as blood cancer, HIV or chemotherapy – have all been linked to an increased risk of hospitalisation or death with COVID-19.
People with these conditions who are at highest risk were initially advised to shield during the peak of the pandemic and all risk groups were then prioritised for vaccination. The government announced the dose interval would be brought forward from 12 to 8 weeks for the clinically vulnerable on 14 May, and everyone in these groups should now have been offered a second dose.
Data on vaccine effectiveness among people in clinical risk groups was previously limited. Though more data is needed, protection against hospitalisation and death in risk groups is expected to be greater than protection against symptomatic disease, as has been seen in studies of the general population.
Dr Mary Ramsay, Head of Immunisation at PHE, said: “This real-world data shows for the first time that most people who are clinically vulnerable to COVID-19 still receive high levels of protection after 2 doses of vaccine.
“It is vital that anyone with an underlying condition gets both doses, especially people with weakened immune systems as they gain so much more benefit from the second dose.”
The Joint Committee on Vaccination and Immunisation (JCVI) advised that those living with immunosuppressed adults should be prioritised for vaccination to help limit the spread of the virus to people in this group.
If the planned booster programme goes ahead, the JCVI has recommended that immunosuppressed adults and their household contacts should also be among the first to be offered a third dose of vaccine in September.
PHE estimates that 30,300 deaths and 8,151,000 infections have been prevented as a result of the COVID-19 vaccination programme, up to 25 June. This is based on modelling analysis from PHE and Cambridge University’s MRC Biostatistics Unit.
PHE also estimates that 46,300 hospitalisations have been prevented in people aged 65 or older in England up to 27 June (approximately 7,000 admissions in those aged 65 to 74, 18,000 in those aged 75 to 84, and 21,300 in those aged 85 and over).
Emergency Department performance figures published by NHS England for June 2021 show the highest number of Type 1 attendances ever recorded, the worst four-hour performance for the month of June, and the highest ever number of total emergency admissions for the month of June.
The data show that in June 2021 1,436,613 patients attended Type 1 Emergency Departments, the highest ever figure since records began.
A total of 400,826 patients were admitted via Type 1 Emergency Departments, the highest ever recorded figure for the month of June.
Four-hour performance in Type 1 departments was 73.2% which is by far the lowest June percentage on record.
1,289 patients were delayed by 12-hours or more in an Emergency Department – almost double the figure of the previous month. It is also the highest ever recorded figure for the month of June, and almost triple the previous highest figure for June recorded in 2019.
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “We have a serious problem in urgent and emergency care. We are deeply concerned. We are facing record breaking figures in the high summer. We can only begin to imagine what this winter may bring.
“We are facing record breaking attendances with a tired workforce and fewer beds; it is seriously challenging. Busy departments are a threat to patient safety, it increases the chance of crowding and corridor care, this risk is significantly increased if covid and non-covid patients are sharing the space for long periods of time.
“We ask that there is a transparent discussion about how the whole of the health service deals with the current levels of demand. Emergency care does not happen in a vacuum but is often the canary of the system. Managing demand in Primary care, the elective backlog and what is happening at the front doors of hospitals is all connected and there is urgent need for a plan that balances these needs in a way everyone can understand.
“The data show what is happening on the ground, and it is likely that things will worsen in the coming months, especially as we enter the winter. The government must realize there is a looming crisis and take swift and urgent action – this is critical ahead of Winter.
“Hospitals can only do all they can to boost capacity, in the face of serious resourcing constraints. And we would ask patients to only attend Emergency Department if they need urgent and emergency care, and seek alternative care, like from their GP or NHS 111, if they have a minor injury or mild condition.
Edinburgh Park’s mass vaccination centre will welcome its final patients this weekend as the site prepares for closure on Sunday.
The mass vaccination centre, based within the Royal Bank of Scotland’s former Younger Building, will close this weekend, having seen thousands of patients come through its doors.
Over the last four months, since the site opened on Monday 1 March, the vaccination team has administered 82,595 doses of the lifesaving vaccine.
NHS Lothian is now in the process of moving to a more flexible delivery model and will utilise more mobile and surge vaccination clinics. This will allow the board to target people who are still to receive their jab by making it as easy as possible to be vaccinated.
The decommissioning of the site will begin on Monday (12 July). Those in the west Edinburgh area wishing to visit a drop-in clinic at a mass vaccination centre can do so at the Royal Highland Showground.
Airport buses have been temporarily diverted to allow passengers to be dropped off directly outside Lowland Hall.
The Edinburgh Park site will still welcome both appointments and drop-ins until closure.
Pat Wynne, Nurse Director of Primary and Community Care, NHS Lothian, said: “The site at RBS has played a key role in the vaccination programme so far and we are really thankful to our team who made it work so well. I would also say thank you to Royal Bank of Scotland for cooperation throughout the site’s operation.
“Anyone wishing to be vaccinated from Monday can do so visiting one of our four mass vaccination drop-in clinics across the region, which are continuing to operate.
“This weekend (10 and 11 July), we will be running our mobile vaccination clinics with the Scottish Ambulance Service at The Centre, Livingston (Sat), and Fort Kinnaird Shopping Centre (Sun).
“These are open to everyone over the age of 18 for first vaccination, and for those who are due their second vaccination having waited eight weeks.”
