From Moreton Health Centre

COVID 19 (coronavirus) , Letters for employers or employees

In the current national crisis, the practice is experiencing high volumes of work with significant staff reduction. The practice will not be able to give letters for employers or employees.
Please read carefully below for detailed guidance which can all be found on www.gov.uk

Extremely High risk patients (recommended for shielding)
These are patients that should be self isolating and avoiding all contact with others for a period of 12 weeks.

The list is as follows:
1. Solid organ transplant recipients.
2. People with specific cancers:
• people with cancer who are undergoing active chemotherapy
• people with lung cancer who are undergoing radical radiotherapy
• people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• people having immunotherapy or other continuing antibody treatments for cancer
• people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
• people who have had bone marrow or stem cell transplants in the last 6 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. Women who are pregnant with significant heart disease, congenital or acquired.

Patients with these conditions should have received a letter from the practice already.
Please note, only severe asthma and COPD are within this group, and this is only patients defined as below:

Taking ALL THREE OF:
▪ a steroid preventer inhaler (at any dose) AND
▪ another preventer medicine (e.g. you are on a combination inhaler, or take a medicine such as formoterol or salmeterol, or tiotropium as well as your steroid inhaler, or if you are taking montelukast) AND
▪ regular or continuous oral steroids (which means you had 4 or more prescriptions for prednisolone between July and December 2019)

Or you have been admitted to hospital in the last 12 months for your asthma

Or you have ever been admitted to an intensive care unit for your asthma.

If you do not fit into this, then your Asthma or COPD does not put you into the extremely high risk patient group.

If you feel you meet the above criteria AND haven’t received a letter for shielding AND you absolutely need a letter because your employer will not accept your own statement, please e-mail the practice explaining which of the above groups you fit in to and this will be checked against your record and a letter sent back by email.

PLEASE DO NOT contact the practice unless you are in one of the groups above.

Patients at Higher risk but NOT extreme risk

This group does not need and WILL NOT be provided with any letters from the practice. The practice cannot ensure it is giving safe medical care if it is dealing with large numbers of unnecessary requests.

The group at higher risks but not extreme risk is as follows:

• lung conditions, such as asthma, COPD, emphysema or bronchitis
• heart disease, such as heart failure
• chronic kidney disease
• liver disease, such as hepatitis
• conditions affecting the brain and nerves, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
• diabetes
• problems with your spleen – for example, sickle celldisease or if you’ve had your spleen removed
• a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tabletsor chemotherapy
• being very overweight (a BMI of 40 or above)

This group of patients should only leave the house for very limited purposes:

• shopping for basic necessities, for example food and medicine, which must be as infrequent as possible
• one form of exercise a day, for example a run, walk, or cycle – alone or with members of your household
• any medical need, including to donate blood, avoid or escape risk of injury or harm, or to provide care or to help a vulnerable person
• travelling for work purposes, but only where you cannot work from home

They DO NOT need letters from the surgery confirming higher but not extreme risk. Employers that pressure employees to get such letters are harming the NHS ability to look after us all, and the practice will not allow this to happen.

Employers should check www.gov.uk for employer guidance on how to support their employees and reduce their risk.

Patient in this group please DO NOT contact the surgery about employment or letters. Please help your NHS to help you in this crisis by not adding unnecessarily and non health critical work.

Once again thank you for your support of the practice.