Langstone Way Surgery
Your health is our priority!

We are here to help in these unusual and exceptional times.
There is a lot of information and changes, too much, so please follow one of these links.

Coronaviruses are a group of viruses that include the common cold, but other members have been more severe but limited in scope:

(a) 2003-2004 SARS (Severe Acute Respiratory Syndrome) affected 8098,with 774 deaths (overall 9.6% fatality, but 55% in those over 65).
(b) 2012-present MERS (Middle East Respiratory Syndrome) affected over 2000, with 600 deaths (>30%), 20% of those found to have antibodies had been asymptomatic.

Covid-19 started in Wuhan, China, 30/1/20 in all mainland China and WHO declared international emergency.

11/2/20 virus designated “SARS-CoV-2” and the WHO assigned the official name of the disease “Covid-19”.

 

  • Early recognition - any new (or onset within the last 7 days) continuous cough or fever 37.8'C or above is possible Coronavirus.
     
  • Don’t panic - most people will be able to self manage without contacting their GP or 111. Everyone needs to follow simple steps to reduce their symptoms and avoid infecting others.
     
  • For information: NHS https://www.nhs.uk/conditions/coronavirus-covid-19/
     
  • 111 online https://111.nhs.uk/covid-19 or download  the NHS app” to your smartphone.
     
  • If your condition deteriorates or you start to feel short of breath (i.e. not able to walk up stairs or are having difficulty speaking in sentences) then DO NOT go to the GP practice or A&E but instead phone NHS 111  (only phone 999 if you feel it is an emergency).
     
  • Self isolate  - stop the virus spreading by self isolating for 7 days from the onset of symptoms and follow information on NHS inform on how to do this. Effective self isolation will stop your friends and family getting infected (see picture below).
     
  • All other household members will need to self-isolate for 14 days, unless they themselves fall ill, in which case they need to isolate for 7 days from onset their own illness.
     
  • Rest, paracetamol and fluids are crucial especially with fever - aim for a minimum of 10x 300ml mugs of fluid a day. Avoid alcohol. Water, diluting juice or fruit juice are ideal.  Aim for regular clear or mildly yellow urine and to be able to pee every 4 hours except when asleep at night. If you have not passed urine in over 4 hours, have dark yellow urine, feel thirsty or dizzy on standing then there is a high chance you are dehydrated and you need to drink lots more as a priority. https://www.nhsinform.scot/campaigns/hydration
     
  • Food is less important than fluids - if able to eat then have lots of fruit and vegetables as these will help your immune system fight the infection.
     
  • Stop certain medications - some drugs are unsafe when you are unwell, especially ones to lower your blood pressure, and anti-inflammatories. Look at the ‘Sick Day Rules’ card for more information (below). 

  • Get support - call family/friends/community members and ask them to deliver supplies. People in the same house as you do not need to self isolate if they have no symptom.
     
  • For children follow advice from the excellent When Should I Worry Website http://www.whenshouldiworry.com/resources/When%20should%20I%20worry-Booklet_Scotland-with%20111%20service_2016.pdf 

Ending isolation

  1. You may end your self-isolation after 7 days if you are feeling better and no longer have a high temperature.
  2. Household members must self-isolate for 14 days.
    If during this time they become unwell, they may return to normal routine after 7 days provided they feel better and no longer a have a high temperature.

Certificates for Enforced Isolation
We will be unable to provide sick notes for Covid isolation. However guidance is given at https://www.gov.uk/government/publications/guidance-to-employers-and-businesses-about-covid-19/guidance-for-employers-and-businesses-on-covid-19

 

"13. Certifying absence from work
By law, medical evidence is not required for the first 7 days of sickness. After 7 days, it is for the employer to determine what evidence they require, if any, from the employee. This does not need to be fit note (Med 3 form) issued by a GP or other doctor.
Your employee will be advised to isolate themselves and not to work in contact with other people by NHS 111 or PHE if they are a carrier of, or have been in contact with, an infectious or contagious disease, such as COVID-19.

We strongly suggest that employers use their discretion around the need for medical evidence for a period of absence where an employee is advised to stay at home due to suspected COVID-19, in accordance with the public health advice being issued by the government."
 
Therefore no one is going to think much of an empolyer who is incapable of using their discretion at this time of national emergency. Further if they fail to use their common sense, then we would make it very clear in any disciplinary/grievance/tribunal reports that under the circumstances we would deem their action inappropriate.

To assist on this, if you have completed the https://111.nhs.uk/covid assessment and it agrees with taking 7-days as a patient, or 14-days as a household member, then an isolation note may be generated by going to https://111.nhs.uk/isolation-note/


Certificates for Social-Isolation
For those people needing to enter extended social-isolation (those over 70 or which stipulated list of chronic conditions or immunosuppression) for the advised 12 weeks, we are again unable to provide certification. However you may ask for a free print out of your medical summary if confirmation of your qualifying health conditions is needed.

If your condition deterioratesCall NHS 111 without delay

In general the incubation (time to show onset of symptoms after exposure) is 5-6 days, but may range between 1-12 days.

Typically symptoms are of
a) 3-7 days flu-like (pyrexia, lassitude , anorexia, myalgia, malaise, sometimes diarrhoea)
b) then onset dry cough, fever & breathlessness
c) symptoms also now include a loss of taste or smell, known as anosmia. 

Initial overview shows that in 82% case the disease is mild, 15% have severe illness requiring hospitalisation, 3% become critically ill needing ventilator support in Intensive Care Units (ITU) and with fatality of 1-2%.

The fatality rate is much higher for those over the age of 80 years (14.7%) and very low for those under the age of 40, with almost no reported deaths under the age of 20.

The disease is much more serious for those people with underlying health conditions. In general, conditions that qualify for the annual flu vaccination programme and include chronic lung disease (such as Chronic Obstructive Pulmonary Disease COPD, Chronic Bronchitis, Emphysema, Asthma), chronic heart disease, diabetes, chronic neurological disorders (such as Parkinson’s, Multiple Sclerosis), other stipulated disorders, PREGNANCY, and those who have suppressed immune system (through, specific diseases, medication or effects of cancer chemotherapy).


If your condition deteriorates, you start to become short of breath (unable to talk in whole sentences or unable to climb 1 flight of stairs if would normally be able to), or become confused:

Call NHS 111 without delay
 

We are still here !

National requirements require us to triage everyone who comes into the building.
Therefore we are operating a "closed-door" policy to prevent people wandering in.
Furthermore we wish people to follow social-distancing and not expose themslves to close contact with others, so please no crowded queuing outside our front door.


ALL appointments are now by telephone triage:
"Are you safe to come?" - we need to ensure that other patients and staff are not put at risk from you.
"Do you need help from a clinician?" - please complete an eConsult form via the link on our Home Page.

If you do not have on-line access, call our receptionsists who will take some details and then allocate a doctor or nurse to call you back within one working day. The doctor or nurse will discuss your query or problem with you, and do their best to resolve the problem without you needing to come to the surgery. If required, prescriptions can be sent electronically to a Pharmacy of your choosing, blood test forms can be left for you to collect or arrangements made for you to drop in clinical specimens. If physcial examination is needed then this will be arranged at a suitable time either via your coming to the surgery or via a Home Visit, at the discretion of the clinician.

We may on occasion also arrange a time to continue the consultation by video link, sending a SMS to your mobile phone to join the two-way video call. This won't be needed or necessarily be approproate for all situations, but again it may help us maintain social-distancing.

Forms/Reports/Specimens
If you need to physically collect prescriptions and test forms, or to hand in specimen samples, then please use the intercom buzzer to the left of the main door.
Please buzz only once - we can see you on CCTV - but bear with us as we are very busy with telephone calls and will respond as quickly as we are able to. 

We really do answer the telephone as quickly as we can, but other people may be ahead of you in the call-queue, so please use eConsult, via the link on our Home Page or via the eConsult website and fill in a form, if possible.If you do  not have on-line access, please call the surgery and a receptionist will take the details from you and complete the eConsult form on your behalf. A clinician will get back to you within one working day.

You can still use Patient Access to request repeat prescriptions on-line, view blood test results and see your medical problem summary.

For confidentiality reasons everyone must register to use the online system to verify your identity and provide you with an access password:

a) Present youself in person to our receptionists with various documents to prove identity... HOWEVER at present we have a "closed door" policy because of the Covid-19 emergency, so instead

b)  Please use the smartphone "NHS app".  

 

Practicalities of self-isolation:

  • If you can, move any vulnerable individuals (such as the elderly and those with underlying health conditions) out of your home, to stay with friends or family for the duration of the home isolation period. If they you cannot move them out of your home, stay away from them as much as possible.
  • Plan ahead and ask others for help to successfully stay at home and consider what can be done for vulnerable people in the household
  • The government advises trying not to go out even for food, so please discuss mutual support with your neighbours, friends and wider family.
  • Drink plenty of fluids and use paracetamol for temperature or pain (there is no clear position on the use of Ibuprofen: the Committee of Human Medicine and National Institute of Clinical Evidence are reviewing this).

Support in these difficult times
Be nice to others, don't socially isolate or fixate on the news. Eat, drink fluids, sleep and maintain contct with your friends and family. Use the telephone, texting, videocalls and dare we say it, follow the residents of Wuhan and Italy in singing from the balconies ! LOL.
Seriously though, set up contacts with your neighbours and local people you know may be vulnerable.

The following is a long list of contacts that you may find useful.

  • Age UK Barnet  For benefit inquiries, support for people aged 55 and above, befriending, handyperson and wellbeing services. Telephone: 020 8203 5040 / 020 8432 1417 Barnet Wellbeing Hub  Meritage Centre, Church End, Hendon, London NW4 4JT Telephone: 0333 344 9088 
  • Citizens Advice Barnet (CAB) *The CAB are offering telephone advice only* Telephone: 0300 456 8365 Monday to Friday: 9:30am to 4pm; Wednesday: 9:30am to 7:30pm
  • Foodbanks Colindale Foodbank - Trinity Church, Northwest Centre, Avion Crescent, Grahame Park Way, London NW9 5QY Opening Times: Tuesdays and Thursdays at 12:00 - 2:30pm 
    Contact Person(s): Lisa Jeffrey and Pat Mansfield  Telephone: 07415 223 963 
    Muswell Hill Foodbank - Pembroke Road Church, 68 Pembroke Road, Muswell Hill London N10 2HT. Opening Times: Monday at 12:30-2:30pm (They are not open on Bank Holidays) Wednesday at 11:30am -1:30pm Friday at 11:30-1:30pm (They are not open on Good Friday)  Email: info@muswellhill.foodbank.org.uk    Telephone: 020 8883 0434
  • Finchley COVID-19 Help / Community Support It is a free service run by volunteers to help people in isolation. The service provides help with providing useful information, picking up shopping, sending post or just a friendly chat. Email: finchley@mutualaid.co.uk Telephone: 07565 321 508 / 07854 902 157 
  • Jewish Care  Hot meals on Wheels to Barnet’s Jewish population. This service has stopped except to those who are already registered  https://www.jewishcare.org Telephone: 020 8922 2222 
  • JGift They can deliver kosher food packages to vulnerable Jewish residents *Please check what SYNAGOGUE the patient belongs to*  Email: keren@jgift.org Telephone: 0208 457 4429
  • MIND Charity For counselling services  Telephone: 0208 519 2122 
  • NW7 Hub Mill Hill Library Building, Hartley Avenue, Mill Hill, London NW7 2HX Telephone: 020 8906 3125 
    Opening Times: Monday - Friday 9:45am-5pm Community Hub. Receiving and distributing goods for the most vulnerable members of the community. 
  • Samaritans They offer listening services and support for anyone struggling to cope Email: jo@samaritains.org Telephone: 116 123 
  • Solace For victims of domestic violence - Solace provides free and confidential support for women and men in Barnet affected by abuse.  Email: barnet.advocacy@solacewomensaid.org Telephone: 020 3874 5003 
  • The Silver Line Charity Free confidential telephone helpline offering information, friendship and advice to older people in the UK. Available 24 hours a day. Telephone: 0800 4 70 80 90 
  • Turn2Us They provide information and support about welfare benefits and charitable grants through an accessible website and a freephone helpline. They also provide assistance with utility bills.  Telephone: 0808 802 2000 
  • Wiltshire Farm Foods They deliver free of charge throughout the UK. The meals are delivered direct to your door by drivers local to you. Telephone: 0800 077 3100 

All prescriptions are now being sent via the Electronic Prescribing System, so if you do not yet have a nominated pharmacy to which we can send your prescription, please call us with details of the pharmacy you have chosen.

Our practice is collaborating with NHS Business Services Authority (NHSBSA) which is providing NHS numbers for those patients suitable for electronic repeat dispensing prescriptions. The information is obtained from NHS prescriptions submitted to the NHSBSA. A member of our clinical team will contact these patients soon to explain the benefits of this service.