ADDED 3rd & 6th 4.20 by SH

Covid19 - not in shielding group

Thanks for your email re SHIELDING. Although you have **** it does not mean that you would be in the highest risk group - UNLESS - you are on regular steroids / immunosuppressants or have been in ITU due to your conditions. Please have another look at the advice page and if you still think you fit the criteria do let us know https://www.gov.uk/government/publications/guidance-on-shie

EPS / Token Details (copy and paste from EPS Rx)

As discussed please find below a Digital CODE BELOW for your prescription. You should be able to present this to any Pharmacy and they should be able to retrieve your prescription. If for any reason this does not work please call reception who will be able to assist. CODE HERE

Covid19 - Breathing Exercises BWS

As discussed the following link will take you to a some Breathing Exercises https://drive.google.com/open?id=1XjRVMqk7_KnG-Q8opGT_JOtVcUAdjX0J This YouTube clip is also helpful https://www.facebook.com/naseem.ahmed.58118774/videos/3345486102147346/ IF you have ANY concerns please call us again or visit https://www.nhs.uk/conditions/coronavirus-covid-19/

Covid19 Nursing - Depot contraceptives - BWS

Due to Coronavirus we are asking patients on Depo injections to postpone these injections to reduce face to face appointments. We will ask the doctor to call you to prescribe some pills insteasd which will have the same effect. The GP would usually offer Desogestrel or a Combnined pill, but will discuss options with you. Thank you for your understanding.

Covid19 Nursing - B12 BWS

B12 injections – due to Coronavirus we have been advised patients on B12 injections to take oral 100mg tablets for the next few months in order to reduce the need for attendance. If you have any concerns please call reception. Thank you for your understanding.

Covid19 Nursing - smears BWS

Due to updated Coronavirus guidance we have made the decision to postpone cervical smear tests for now. Please only attend for your smear test appointment if your last test was abnormal or you have abnormal bleeding/symptoms. If you have any concerns please call reeception. Thank you for your understanding

BWS document link by sms

As discussed please find a link so that you can download your paperwork. If your employer insists on a hard copy for any reason please call reception and we can leave a hard copy for you to collect - or send us a SAE and we can post back to you.

ADDED 23.3.20

Covid19 asthma rescue packs

We are aware that there has been some false info circulating to advise asthma patients to get 'rescue packs' & inhalers. Please be reassured this is NOT standard NHS advice. There is no evidence that steroid help Covid19, and in fact could make it worse for some. If you have symptoms please see 111 or call the Practice. If too many patients request inhalers there could be supply issues for others.

Asthma - Inhaler / spacer use (BWS)

It is very important to use correct technique with inhalers so as to ensure all the medicine is evenly distributed in your lung for maximal effect. Please use the link below regarding inhaler technique and use of spacers. Please BRING YOUR INHALERS with you when you attend for for an asthma review. https://www.asthma.org.uk/advice/inhaler-videos/

AMENDED 20.3.20 (to include 111 sick note link)

Covid19 link to online Sick note

As discussed, your employer should not normally be requesting a formal Medical Certificate during this Covid emergency. The NHS does not feel this is a good use of GP time at the moment. Please use this link for a formal note if you are self isolating. https://111.nhs.uk/isolation-note  We wish you better.

ADDED 20.3.20

Covid19 - DNA 1st call

We called you back just now regarding your enquiry without success. As you can imagine we have a very high call volume. You might find an answer here https://111.nhs.uk/covid-19 . We will try you ONCE more in the next hour. PLEASE KEEP YOUR PHONE FREE TO RECEIVE OUR CALL. Our Practice policy is to CLOSE a call after 2 failed attempts. Thank you for your co-operation.

AMENDED 20.3.20

Covid19 Generic Advice & Red Flags (BWS)

See link to the NHS Covid19 advice. For most people the Coronavirus is a mild self-limiting infection. We hope you feel better. DRINK PLENTY OF FLUIDS. If you become unwell (particularly any shortness of breath) please visit 111 or contact the Practice. DO NOT TAKE ANY IBUPROFEN TYPE MEDICATION (NSAIDs). Kind regards. Bridgewater Surgeries. https://www.nhs.uk/conditions/coronavirus-covid-19/

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Covid19 Generic Advice & Red Flags (BWS)

See link to the NHS Covid19 advice. For most people the Coronavirus is a mild self-limiting infection. We hope you feel better. If you become unwell (particularly any shortness of breath) pls visit 111 or contact the Practice. DO NOT TAKE ANY IBUPROFEN TYPE MEDICATION (NSAIDs).  Kind regards. Bridgewater Surgeries.

https://www.nhs.uk/conditions/coronavirus-covid-19/

Added 17.3.20 at 12.23 by SH

Covid19 High risk groups advice

We understand your natural concerns re Covid19. High risks include elderly & anyone normally eligible for a FLU JAB. This includes pregnancy, immune drug therapy & obese if BMI > 40. See https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults

Added 17.3.20 at 12.23 by SH

Covid19 check up call / text

Hope you are doing ok. Tried to call just now to catch up and check how you are - no reply. Please could you either TEXT me back using the LINK BELOW - or alternatively leave me a message via Reception so that we know you are safe and well

Added  17.3.2020 at 09.05 by SH

Covid19 - Patient has arrived ONE OFF REPLY

Your appointment time is soon. Please use the ONE OFF LINK BELOW to let us know you have arrived. PLEASE DO NOT ENTER THE BUILDING UNTIL YOU ARE CALLED. You will be escorted inside & might be asked to wear a face mask. You will be seen alone unless you need a carer or guardian with you. Thank you for your co-operation. If for any reason you are not called in the next 15 minutes, pls call reception

Covid19 - called x2 - call closed

We have tried to call you back twice now regarding your enquiry without success. As you can imagine we have a very high call volume at present. If you still need advice see https://111.nhs.uk/covid-19 or call us again. Our policy is to close calls after 2 failed attempts to rtn a query. If you call back PLEASE ENSURE WE HAVE YOUR CORRECT NUMBER AND PLEASE KEEP YOUR PHONE FREE TO RECEIVE OUR CALL

Added  16.3.2020 at 11.20 by SH

Covid19 - needs visit

Listening to your symptoms you will need a home visit today. The Clinician will be wearing basic protective clothing (gown / mask / gloves). We will visit as soon as possible, but due to high call demand at present we may be some hours to reach you. If your symptoms change or deteriorate while waiting, please call us again - or ONLY in an emergency 999.

Added  16.3.2020 at 10.15 by SH

Covid19 Spacer issued

As discussed - we suggest that you use a SPACER device as this really helps delivery of your inhaled medicines. Please follow these links for info https://www.asthma.org.uk/advice/inhalers-medicines-treatments/inhalers-and-spacers/spacers/ https://www.asthma.org.uk/advice/inhaler-videos/pmdi/ If you have any concerns please call us again or see 111.

Added  16.3.2020 at 09.25 by SH

Covid19 - given HOT slot- advised wait OUTSIDE pls

As discussed you will be seen today in our 'urgent clinic' . Please BRING YOUR MOBILE and DO NOT enter the building UNTIL YOU ARE CALLED. This is to PREVENT exposure to other patients / staff. You will be seen on the ground floor in a clean 'isolation room'. The GP will be wearing protective (gloves / gown / mask) & you will NOT have use of toilets. The GP will see you as quickly as possible. TY

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Covid19 ABx issues as 'best interest' decision

As discussed. We would normally arrange to see you for a face to face assessment. However on this occasion have issued antibiotics due to Covid19 emergency measures. This is a 'best interest decision’ made in a crisis situation to prevent an unnecessary visit for you to practice. If you have any concerns please call again or visit 111. Thank you for your understanding.

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Covid 19 called to cancel pt no reply (BWS)

I was calling just now to try and see if I can help you by phone but there was no reply. Unfortunately all our routine appointments have been cancelled this week due to the Covid19 emergency. Please call the practice during normal working hours if you still need to see / speak to a GP - or visit 111, your local Pharmacist (or 999 in an emergency)

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Covid19 advised to contact 111 (BWS)

As discussed, your symptoms may suggest that you have Coronavirus. Please visit the following web site https://111.nhs.uk/covid-19/ If you do not have internet access you will need to call 111 but please be aware that there might be a long waiting time. If the online or 111 advise you to contact the GP please call us back. Kind regards, Bridgewater Surgeries

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Covid19 Routine appointment has been cancelled

Apologies. Due to the emergency Covid19 national emergency we have been forced to cancel all pre-booked routine GP appointments. PLEASE DO NOT ATTEND THE PRACTICE FOR YOUR APPOINTMENT. If you still need medical advice please call reception during normal working hours who will assist you. We thank you for your co-operation and understanding.

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Covid19 Self Isolation Advice (BWS)

As discussed here is a link to the NHS self isolation advice. Please remember that for most people the Coronavirus is a mild self limiting infection. We hope you feel better, but if you become unwell (particularly any shortness of breath) please visit 111 or contact the Practice. Kind regards. Bridgewater Surgeries. https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/

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Covid19 Signpost to Covid 111 while awaiting GP

Thank you for calling, on of our Team will call you back as soon as possible. We apologise for the delay due to high demand. WHILE WAITING for a call back today, if you have access please visit https://111.nhs.uk/Question/Navigation If you feel very unwell / short of breath and ONLY in an emergency call 999. Otherwise please wait and we will get back to you asap

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Infection - Length of illnesses

For information. These are the expected time for resolution of your symptoms' Average length of symptoms Middle-ear infection 4 days, Sore throat 7 days, Common cold 10 days, Sinusitis 18 days, Cough or bronchitis 21 days. We hope you feel better. Please see your local Pharmacist, GP or 111 for further advice & help.

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Infection-Ear infection ? OM (BWS)

NHS guidance is not to treat ear infections under 2 days duration unless you are very unwell with high fever & discharging ear. There is an 80% (4/5) chance you will be better after 48hrs & most patients recover with no treatment within 5 days. If you are concerned please contact GP or 111. For more info see https://www.nhs.uk/conditions/ear-infections/

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Infection-Earache only advice (BWS)

As discussed please try some pain relief for your earache. NHS guidance is that we do not usually need to see or treat any ear pain under 2 days duration, unless you have facial weakness, you feel very unwell (despite pain relief), or you are under 2 years of age. Please see this link for further information https://www.nhs.uk/conditions/earache/

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Infection-Sinusitis advice (BWS)

As discussed it sounds like you have sinusitis. You could see your local Pharmacist for advice. NHS guidance is not to use antibiotics routinely as 80% (4 out of 5) cases resolve within 14 days with self care. However, if you start to feel unwell, develop one sided facial swelling or a high fever with bloody nasal discharge please contact us again or 111. We hope you feel better.

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Infection-UTI advice if empirical ABx issued (BWS)

As discussed we have issued a prescription for what sounds like a simple urine infection. However if you feel more unwell - especially if you develop loin pain / tenderness, vomiting or become unable to walk without being dizzy (this can signify low BP) please call us or 111 as this could be a sign of kidney infection (pyelonephritis) and you would need urgent review. We hope you feel better.

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Infection-When Should I worry

Please check this link "When should i worry"

http://www.whenshouldiworry.com/resources/When%20should%20I%20worry-Booklet_England-with%20111%20service_2016.pdf For children

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URTI advce

As discussed your symptoms seem in keeping with a minor illness. Please note the Natural history and average illness length for common respiratory tract infections: Middle-ear infection 4 days, Sore throat 7 days, Common cold 10 days, Sinusitis 18 days Cough or bronchitis 21 days. If you are worried about your child this website is very helpful http://www.whenshouldiworry.com/

List created as part of emergency contingency planning by:

Dr Mohammed Amin

Dr Simon Hodes

Dr Ketan Shah

15.3.20

Bridgewater Surgeries

Watford

https://bridgewatersurgeries.nhs.uk/