GP practices and pharmacies open for Easter

Extended opening hours to ensure services available

General practices and community pharmacies will remain open on Good Friday and Easter Monday to help relieve pressure on out-of-hours services this weekend.

GPs will be open to offer treatment for non-coronavirus (COVID-19) related health issues, where it is safe to do so. Community pharmacies have also been requested to remain open where possible to support the wider efforts of the NHS.

Patients with coronavirus (COVID-19) symptoms are asked to check nhsinform.scot/coronavirus first for advice or dial NHS 24 on 111, day or night, if their symptoms worsen or do not improve after seven days.

Health Secretary Jeane Freeman said: “I want to thank all health and social care staff for their continuing extraordinary efforts as we face this pandemic.

“Given ongoing demand on our NHS, I have taken the unusual step of asking GP practices and community pharmacies to remain open on Good Friday and Easter Monday – but only if it is safe to do so.

“Working with the Scottish GP Committee of BMA Scotland, the Scottish Government has agreed an additional £15 million to help GP practices meet the costs of responding to COVID-19.

“Part of this will help to cover the cost of remaining open on Good Friday and Easter Monday and the remainder will help to meet other costs being faced by practices during this difficult time. I have also been clear that the Scottish Government will meet any additional costs incurred by community pharmacies to remain open on these bank holidays.

“As always – if you have a critical medical emergency, whether related to coronavirus or not, phone 999.”

NHS Inform’s coronavirus webpage is still the fastest way for people to get the latest health advice and information.

Extra support for people affected by drug and alcohol use

Extra support for people affected by alcohol and drug use during the coronavirus (COVID-19) pandemic has been announced by the Minister for Public Health Joe FitzPatrick.

Funding of £166,000 from the Scottish Government will support:

• a programme to increase access to naloxone in new settings, including investment in kits to add to the existing outlets for naloxone supply
• increased capacity within the Know the Score helpline and webchat service
• a COVID-19 publicity campaign signposting support for alcohol and drug users during the pandemic
• funding to link people with others in recovery through the Scottish Recovery Consortium

Help will also be available for those affected by another’s alcohol and drug use through the Supporting Families Fund. This includes a discretionary emergency fund for families, online wellbeing activities, family meals, wellbeing packs and counselling support.

Mr FitzPatrick said: “Responding to the coronavirus pandemic is one of the biggest challenges of our lifetime and it will disrupt so many lives like never before. Protecting and supporting everyone during these unprecedented times is our priority.

“We’ve worked closely with organisations on the frontline to create this package of measures to ensure we continue to support those affected by alcohol and drug use.

“By working together and observing the latest guidance, we can all play our part in keeping everyone safe.”

Boris Johnson admitted to hospital

Prime Minister Boris Johnson has been admitted to hospital for tests, ten days after testing positive for coronavirus.

While the Queen was addressing the nation in a television broadcast last night, Boris Johnson (55) was on his way to hospital, where he remains this morning.

Foreign Secretary Dominic Raab will chair this morning’s Coronavirus update cabinet meeting in Downing Street.

A statement issued by 10 Downing Street last night said: “On the advice of his doctor, the Prime Minister has tonight been admitted to hospital for tests.

“This is a precautionary step, as the Prime Minister continues to have persistent symptoms of coronavirus ten days after testing positive for the virus.

“The Prime Minister thanks NHS staff for all of their incredible hard work and urges the public to continue to follow the Government’s advice to stay at home, protect the NHS and save lives.”

Catherine Calderwood resigns

Scotland’s Chief Medical Officer Dr Catherine Calderwood resigned from the Scottish Government late last night.

Dr Calderwood had earlier offered an apology for ignoring public health guidelines on not travelling away from home – not once, but twice – at a deeply uncomfortable press conference.

Ms Calderwood’s apology was never going to be enough to appease growing public anger, however. To break your own rules once is perhaps a mistake, but to repeat the offence a week later is quite simply unforgiveable. Scotland’s senior health official had to go – and really should have resigned sooner.

First Minister Nicola Sturgeon tried to protect Ms Calderwood at yesterday’s media briefing, but it later became clear that public furore was not dissipating.

The Chief Medical Officer’s position as one of the most recognised faces of Scotland’s fight against the coronavirus was untenable.

With public confidence draining, Ms Calderwood bowed to the inevitable and tendered her resignation. In a statement issued late last night, Dr Calderwood said: “I am deeply sorry for my actions and the mistakes I have made.

“The First Minister and I have had a further conversation this evening and we have agreed that the justifiable focus on my behaviour risks becoming a distraction from the hugely important job that government and the medical profession has to do in getting the country through this coronavirus pandemic.

“Having worked so hard on the government’s response, that is the last thing I want.

“The most important thing to me now and over the next few very difficult months is that people across Scotland know what they need to do to reduce the spread of this virus and that means they must have complete trust in those who give them advice.  It is with a heavy heart that I resign as Chief Medical Officer.

“I will work with my team over the next few days to ensure a smooth transition to my successor.”

Catherine Calderwood’s actions really could not have come at a worse time. The coronavirus is yet to peak in the UK, and Ms Calderwood had a key role in getting the public health message out to Scots during these hugely difficult times.

The Chief Medical Officer’s departure is undoubtedly a personal blow to First Minister Nicola Sturgeon – it’s a distraction she could well have done without as she leads the country in the great challenges we face.

First Minister Nicola Sturgeon said last night: “Dr Calderwood’s advice to me, to the government and to people across Scotland over the past few weeks has been the right advice. People should continue to stay at home to protect the NHS and to save lives.

“It is however clear that the mistake she made – even though she has apologised sincerely and honourably for it – risks distracting from and undermining confidence in the government’s public health message at this crucial time. That is not a risk either of us is willing to take.

“Catherine has been a transformational CMO, bringing changes to the way medicine is delivered in Scotland and in particular using her experience to bring an overdue focus to women’s health. Also, as I said earlier, her advice to me on Coronavirus will be missed – which is why she will work to ensure a smooth transition in the days ahead.

“While she has made a very serious mistake in her actions, that should not detract from the fact that as CMO she has made a highly valuable contribution to the medical profession and to health in Scotland, and I have no doubt she will continue to do so in future. She leaves office with my thanks and admiration.”

 

Smokers at greater risk of severe respiratory disease from COVID-19

Emerging evidence from China shows smokers with COVID-19 are 14 times more likely to develop severe respiratory disease.

If you smoke, you are not only putting yourself at greater risk of developing severe disease from the COVID-19 virus, but those around you exposed to second hand smoke, including children, are also put at increased risk.

Smoking tobacco is known to damage the lungs and airways causing a range of severe respiratory problems. The evidence clearly shows COVID-19 virus attacks the respiratory system, which explains why smokers are at greater risk. A small but highly impactful survey from China finds that smokers with COVID-19 are 14 times more likely to develop severe disease.

In addition, the repetitive hand to mouth movement provides an easy route of entry for the virus, putting smokers at greater risk of contracting COVID-19.

Professor John Newton, Director of Health Improvement at Public Health England said: “In light of this unprecedented COVID-19 pandemic, there has never been a more important time to stop smoking. Not only for your own health but to protect those around you.

“It will also help alleviate the huge pressures on the NHS.

“It is never too late to quit, no matter your age.”

Once smokefree, there are very real health benefits with the body continuing to repair the longer you stay smokefree.

The more immediate benefits include:

  • after 48 hours carbon monoxide is eliminated from the body. Lungs start to clear out mucus and other smoking debris
  • after 72 hours breathing becomes easier as bronchial tubes begin to relax
  • after 2 to 12 weeks blood circulation improves, making physical activity like walking and running easier

To help reduce your risk of contracting the virus and developing severe disease from coronavirus, you can use the smokefree app to access advice and support on how you can best stop smoking. Search ‘Smokefree’.

Follow the Smokefree Action Coalition #quitforcovid campaign on Twitter.

Deliveries begin for high risk groups

People in Scotland at highest risk of severe illness from coronavirus (COVID-19) will begin to receive home deliveries of essential groceries today.

Letters from the Chief Medical Officer have been issuing this week to those who are at greatest risk of COVID-19, to provide bespoke guidance on shielding from infection and information about the support available, which includes access to home deliveries through a text message service.

People who have received the letter this week and signed up to the service have been texted with the option of starting their weekly deliveries of essential food items including soup, pasta, rice, fruit, vegetables, tea, coffee and biscuits, as well as toiletries such as shower gel and toilet roll, on Friday.

Other measures being put in place include:

  • Specialist medicines such as chemotherapy drugs delivered through local health boards
  • Local Resilience Partnerships working with Community Pharmacy to scale up deliveries of pharmacy medicines
  • Work with supermarkets to ensure priority delivery slots for people at high clinical risk

Deputy First Minister John Swinney said: “These new services are available to those at the highest risk of severe illness from COVID-19 who do not have support structures around them to help.

“This includes people with specific forms of cancer, severe respiratory conditions, certain rare diseases, recipients of organ transplants, those on immunosuppression therapies and pregnant women with congenital heart disease.

“Many people will have support from friends and family but I would encourage everyone who receives a letter and requires support to sign up to the service immediately – this will ensure you have adequate supplies of food and essential items during these challenging times.

“It is vitally important that people at highest clinical risk are shielded as much as possible, and our advice alongside this text service will help protect people from the detrimental effects of the virus, including disruption to health and social care and key services.

“Our local services must prioritise those most in need and – by doing so – we will protect them, reduce the burden on the NHS and save lives. By continuing to work together, we can all play our part in keeping everyone safe.” 

Those in the high risk group who do not have access to mobile phones will be able to register for deliveries through their local authority.

Contact details are on the NHS Inform website and can also be accessed through the main switchboard number for local councils.

The grocery delivery service will be led by Brakes and Bidfood with the first deliveries expected on 3 April.

The six categories of risk – as agreed by the UK’s Chief Medical Officers – are:

1. Solid organ transplant recipients

2. People with specific cancers:
a. People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
b. People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
c. People having immunotherapy or other continuing antibody treatments for cancer
d. People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
e. People who have had bone marrow or stem cell transplants in the last six months, or who are still taking immunosuppression drugs

3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD

4. People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)

5. People on immunosuppression therapies sufficient to significantly increase risk of infection

6. People who are pregnant with significant congenital heart disease

Initial estimates of the numbers involved were 150,000-200,000, however, a large number of people have been found to qualify in more than one category, and examination of patient records has identified patients who do not fall into the categories and do not need to apply such stringent measures to protect themselves.

In Awe of our Carers

SCOTS are being urged to show their appreciation for the work of Scotland’s vast army of social care workers who are continuing to provide vital services to older and vulnerable people during the Coronavirus crisis.

Leading housing and care provider Blackwood is promoting a campaign to shine a light on the important front-line role care employees are playing – and to encourage businesses and individuals to look at ways they can show their gratitude.

Across Scotland, it is estimated that up to 150,000 staff work in the social care sector, providing care to people in care homes and retirement developments as well as care-at-home services.

Blackwood Chief Executive Fanchea Kelly said:  “Many older and vulnerable people could require hospital care without the help of our wonderful care staff. This vital support is happening in our communities in an almost invisible way during the COVID-19 crisis.

“In Blackwood we believe it is essential to recognise this important work publicly. We’d like to let care staff know that they are appreciated, keeping morale high at a time where many people are going way beyond their normal duties. If you can do anything to show your support, we’d love to hear from you.

“The first thing you can do is to join our campaign #ImInAwe so please tweet, retweet and share far and wide to get behind our carers and show how much they are valued.

“And I want to say thanks to members of Edinburgh Sports Club for volunteering to help drive our carers to their shifts as public transport services decrease.

“If you or your business can help in your own way, get in touch, we would love to hear from you to put a collective show of support across Scotland. But most importantly use ‘#ImInAwe‘ to show you care.”

Blackwood aims to help people live their life to the full, by providing services which support individuals to live independently. It specialises in technology and design innovation to support the role of its housing and care staff across Scotland.

For more information, please visit: https://www.blackwoodgroup.org.uk 

New guidelines to protect frontline staff

New guidance on personal protective equipment (PPE) has been published for health and social care workers responding to coronavirus (COVID-19) in Scotland.

The guidance, which has been agreed by the four UK Chief Medical Officers and Chief Nursing Officers, follows an urgent review of the existing guidance against the latest evidence and WHO advice, on the safest way to protect health and social care staff.

The new guidance includes:

  • what type of PPE to use in secondary, primary and community care settings, and when to wear it
  • when clinicians need to wear a higher level of protective equipment, and in which settings
  • detailed advice around risk assessing use of PPE in a range of different clinical scenarios, including community settings, such as care homes and caring for individuals in their own homes

Health Secretary Jeane Freeman said: “Protecting staff working on the frontline is an absolute priority and I want to thank each and every one of them for their hard work and commitment in this incredibly challenging situation.

“I want our staff to feel as safe as possible and this updated guidance provides clarity so that health and social care staff caring for patients feel confident in which PPE they need to wear in different situations and settings.”

Scotland’s Chief Medical Officer Dr Catherine Calderwood said: “The updates to the guidance reflect the fact that COVID-19 is now widespread in the community, so health and social care workers are more likely to see patients with the virus, some of whom will not have symptoms yet.

“We have introduced new measures to improve the distribution of PPE, including a single point of contact for all health boards to manage local PPE supply and distribution, and an email address for NHS staff to contact if they do not have what they need. This is covid-19-health-PPE@gov.scot. It will be monitored continuously and allow us to act to resolve any specific supply issues more quickly.

“A helpline has also been set up for registered social care providers having problems accessing PPE, with extra staff to prepare orders for social care, additional delivery drivers, longer delivery hours and use of more external delivery companies to increase capacity. Work continues to source further PPE and ensure there is an appropriate supply for all our workforce.”

The Scottish Government also outlined details of the improved process to report COVID-19 deaths that began yesterday.

As part of this new system, 40 deaths, which would not yet have been reported under the old system – because next of kin had not been informed – have been included and allocated to the last three days as appropriate.

The data below shows the running total of the number of deaths reported, under the old and new systems, of those confirmed to have died from Coronavirus across the last few days. There are now 126 deaths confirmed using the new system:

Tuesday 31 March – 69 (previously 60)

Wednesday 1 April – 97 (76)

Thursday 2 April – 126 (86).

 

Stung into action: Hancock unveils testing plans

England will carry out 100,000 tests for coronavirus every day by the end of this month, Health Secretary Matt Hancock pledged yesterday.

Increased testing for the NHS will form part of a new 5-pillar plan, bringing together government, industry, academia, the NHS and many others, to dramatically increase the number of tests being carried out each day.

Mr Hancock’s announcement comes following increasing criticism of the government’s slow response to both testing for coronavirus and provision of vital personal protective equipment (PPE).

On Wednesday, trade unions urged the government to ensure essential workers get access to live-saving protective equipment in an open letter to ministers.

The letter, signed by the TUC, UNISON, RCM, GMB, Unite, BDA and CSP, said: “Our members care for the sick and the elderly, they look after our children and keep them safe, they make sure there is food on the supermarket shelves, they keep the lights on and the water running.

“We are weeks into fighting Covid-19. It is now clear that the lack of personal protective equipment for frontline workers has become a crisis within a crisis.”

The letter adds: “Workers are being exposed to unreasonable and unnecessary risk by the ongoing failure to provide key workers with adequate PPE.

“Every day we hear from our members that despite repeated assurances from government, people are being asked to work with inadequate or out of date protective equipment – and that is where PPE is being provided at all.”

The letter states starkly the risks faced by key workers. “They are risking their own health and safety for us. We must be clear what that means, those who are subject to prolonged and direct exposure to the virus – such as health and social care professionals – are risking their lives.”

Calling for urgent government action to increase PPE supply, the letter adds there must be “transparency on procurement, distribution, timescales and exactly how and when workers can expect to get the protection they need and deserve,” adding “we call on the government and employers to guarantee that no member of staff will be put under pressure to perform tasks without adequate protective equipment.”

The call was backed by Labour health spokesperson John Ashworth. “Labour calls on ministers to abandon attempts to gag staff and instead work closely with trade  unions to ensure staff get the PPE that is so crucial to keeping them and patients safe,” he said.

The appeal – and, perhaps more importantly, criticism from loyal government supporting newspapers including the Daily Mail and the Telegraph – appears to have had an effect and the government has been stung into action.

Professor John Newton the Director of Health Improvement for Public Health England, has been appointed to help deliver the new plans and bring together industry, universities, NHS and government behind the ambitious testing targets.

He will coordinate a national effort with global manufacturers encouraged to expand their manufacturing capacity here in England; our strongest, home grown businesses in life sciences and other industries are encouraged to turn their resources to creating and rolling out mass testing at scale, and the government will support anyone with a scalable scientific idea or innovation to start a business.

New testing capabilities for the NHS and their families will support staff who are isolating at home to return safely to work if the test is negative, and keep themselves and others safe if the test is positive.

Significant progress to increase testing has already taken place across the country to protect the vulnerable, support our NHS, and ultimately save lives. New testing centres have been established at the main hotspots of the disease, and the UK has already conducted more than 152,000 tests. The 5-pillar plan sets targets to expand the England’s capability further.

The new 5-pillar plan outlines the ambitions to:

  • Scale up swab testing in PHE labs and NHS hospitals for those with a medical need and the most critical workers to 25,000 a day by mid to late April;
  • Deliver increased commercial swab testing for critical key workers in the NHS, before then expanding to key workers in other sectors;
  • Develop blood testing to help know if people have the right antibodies and so have high levels of immunity to coronavirus;
  • Conduct surveillance testing to learn more about the spread of the disease and help develop new tests and treatments; and
  • Create a new National Effort for testing, to build a mass-testing capacity at a completely new scale.

Once widespread testing is available, we will prioritise repeated testing of critical key workers, to keep them safe and make sure that they do not spread the virus.

Over time, plans announced today will also see increasing focus on testing to see if people have already had the virus, to identify if they have the antibodies that will give them immunity against catching it again. This science is new and developing, but the aim is for a successful test that can be rolled out at scale, that could allow critical workers – and then the wider population – to return to work and their daily lives.

The Health Secretary also announced that over £13 BILLION of debt will be written off as part of a major financial reset for NHS providers – and community pharmacies will also receive a £300 million boost.

Seems the government has found that magic money tree after all!

Health workers do-it-themselves to tackle ventilator shortages

The First Minister has thanked clinical physics teams across Scotland in Parliament for their efforts on increasing ventilator capacity by repurposing equipment.

NHS staff have helped boost the stock of ventilators, crucial for the care of those suffering from coronavirus (COVID-19), by repurposing more than 200 anaesthetic machines.

These machines, normally used in operating theatres outwith intensive care units (ICU), will supplement the stock of specialised ICU ventilators.

NHS boards will deploy them as an interim measure with staff currently being retrained to use them in this way.

The use of repurposed machines increases ICU bed availability to more than 500. More ventilators for the NHS in Scotland have been ordered from a range of manufacturers and these will arrive in the coming weeks.

First Minister Nicola Sturgeon said: “Expert NHS clinicians, medical physicists and technicians have worked tirelessly, particularly over the last few days, to increase the ventilation capacity in our NHS by repurposing anaesthetic machines in response to COVID-19.

“Their remarkable work means our NHS has not just doubled ICU capacity, but has tripled it, ahead of the arrival of the additional ventilators we have ordered.

“We are now working to quadruple ICU capacity for COVID-19 patients to beyond 700 ICU beds, as soon as that can be achieved.

“These measures are part of our concerted and sustained response to an unprecedented health emergency. I am deeply grateful to our NHS staff for their ongoing commitment, expertise and bravery during this outbreak.”

Consultant Intensive Care Anaesthetist and Scottish Critical Care Clinical Lead Dr Rory Mackenzie said: “Over the last month ICU clinicians across Scotland have been fully committed to delivering detailed plans to increase the number of ventilator beds to meet the anticipated demand due to COVID-19.

“These plans include expanding into new spaces not normally used for critical care and repurposing anaesthetic machine ventilators, normally used in the operating theatre environment, to supplement specialised ICU ventilators.

“Most importantly, staff with previous ICU experience and others released from elective care programmes have gone through additional training.

“This is to ensure they can provide essential support and assistance to core critical care staff in the delivery of invasive ventilation, within these significantly enlarged units, to the sickest patients for whom this treatment provides a realistic prospect of survival.”

Scottish Government Senior Medical Advisor and Consultant Intensive Care Anaesthetist Dr John Colvin said: “From working collaboratively with clinical and technical staff across NHS Scotland, we are now confident that we are able to provide more than three times the normal number of ICU beds, and are on course to quadruple Intensive Care Capacity.

“A key advantage is that the extra medical and nursing staff from anaesthetics who will be contributing to the ICU escalation care will be familiar and confident with this equipment. ”

NHS Greater Glasgow and Clyde’s clinical physics team have converted 100 anaesthetic machines to ventilators. 

The First Minister thanked clinical physics teams across Scotland in Parliament today for their efforts on increasing ventilator capacity by repurposing equipment.

This is part of the board’s overall mobilisation plan to quadruple critical care capacity to cope with COVID-19, as requested by the Scottish Government.

Patients with coronavirus often have difficulty breathing and ventilators are used in hospital to help with this.

A team of 12 technicians in the past few days converted the medical equipment at Glasgow Royal Infirmary, Queen Elizabeth University Hospital and Royal Alexandra Hospital.

They were able to do this by changing the machines’ inner tubing to use air instead of oxygen to operate the ventilator. The machines were then tested, calibrated and are now approved for use to treat patients with coronavirus.

The clinical physics team at NHS Greater Glasgow and Clyde maintain the medical equipment in our hospitals.

This is part of NHS Greater Glasgow’s overall response to COVID-19 as the board aims to protect its patients, staff and wider public.

Ted Mullen, Head of Medical Equipment Management, part of the wider Clinical Physics Team, NHS Greater Glasgow and Clyde (above), said: Our team of experts did an incredible job this past weekend to convert our anaesthetic machines to much-needed ventilators.

“I want to thank them for their tireless work on this. These ventilators will help our frontline staff treat patients with coronavirus.”