Coronavirus and changes to our normal services

Some of the other steps being taken at UHDB to protect our patients, staff and to maintain essential services include:
 

• A Receiving Unit has been set up at Royal Derby Hospital > to triage patients into one of the three seperate Emergency Departments. 
   
• The way that patients are seen and cared for at Queen's Hospital Burton's A&E has changed >, with a clinical navigator based in the reception to direct patients to one of two majors areas.
   
• The Midwifery-led birthing unit at Samuel Johnson Community Hospital has temporarily closed. These experienced midwives have been redeployed to Queen’s Hospital Burton, in order to provide enhanced support for our pregnant women.
   
• It is extremely important that during the Coronavirus pandemic, all pregnant women continue to access regular care throughout their pregnancy and following the birth of their baby. We’ve made some changes to our maternity services > and to support a positive birth experience for all.
   
• From Monday 6 April 2020, phlebotomy walk-in clinics will be run from the outpatients department at Samuel Johnson Community Hospital > and not at Sir Robert Peel Community Hospital, as before.
     
• All day case surgery has been rescheduled, in order to reduce non-essential visits to our hospitals.
   
• Some elective operations have been rescheduled.
   
• Most outpatient appointments are now being conducted by phone or video, or have been rescheduled. We will call any patients who are affected by this.
   
• The Trust is still accepting referrals from GPs, although patients may face longer waits than normal to be seen. Appointments may be conducted by phone or video, or have to be rearranged, based on the patients’ clinical need.
   
• Derby and Burton Homebirth Services have been suspended until further notice. All of our women who’d planned for a homebirth have been contacted and made aware.
   
• Audiology service changes during Coronavirus >. Audiology hearing aid repair and maintenance servicing at Queen's Hospital Burton, Samuel Johnson Community Hospital in Lichfield and Sir Robert Peel Community Hospital in Tamworth is also operating remotely. 

Cohort wards have been set up in protected locations across Royal Derby Hospital and Queen’s Hospital Burton for patients who have suspected or confirmed COVID-19. These wards are staffed by teams of highly experienced doctors, nurses and other colleagues who are appropriately trained and equipped to provide this care effectively.

Please rest assured that all of our key workers on the wards are being issued with all of the necessary Personal Protective Equipment (PPE) and are strictly following national guidance around infection control, to keep both themselves and our patients safe.

Treatment

Maintaining patient safety is a priority and changes may be necessary as the situation evolves. For example, your specialist teams may encourage phone consultation rather than seeing you in person, to minimise any risk to you.

Protect yourself

Stay up to date with the latest guidance:

• the NHS guidance on Coronavirus >
• Public Health England guidance on Coronavirus >

If you have symptoms of coronavirus

• Symptoms include a high temperature, a persistent cough and a loss of taste or smell
• If you have symptoms of coronavirus, use the NHS 111 online tool for advice on what to do. You should also speak to the hospital department responsible for your care:

Bringing relatives to appointments

In order to minimise crowding, we ask you to travel alone to the hospital if you’re able, in line with national social distancing advice.

If you have anyone coming with you when you have your treatment, they should wait outside the hospital. This helps us minimise further risk to you and other patients.

We appreciate this is a difficult time so if you have any concerns, please speak to the nurse in charge on the day of your appointment.

Risk to previous cancer patients

Most people make a full recovery after cancer treatment and their immune system either recovers fully or is not affected. But the type of cancer and the treatment you have had may increase your risk from coronavirus.

If you are taking hormone tablets or injections for cancer, you are at no more risk of contracting coronavirus. You should continue your medication and take the appropriate hand washing and social distancing measures.

Find out more about the risks of coronavirus to cancer patients >.

Advice for carers

If you care for someone with cancer or receiving cancer treatment, you should follow social distancing measures and take extra care to protect them from coronavirus.

If you have symptoms of coronavirus and you live with someone with cancer, you should try to arrange for them to stay with family or friends for 14 days while you self-isolate.

Find out more about guidance for carers concerned about coronavirus >.

For full information on advice for pregant women see our Maternity Services during Coronavirus >.

There is currently no evidence to suggest that coronavirus poses a greater risk if you are pregnant than it does to other healthy people, but the Royal College of Obstetricians and Gynaecologists > have welcomed the government’s precautionary approach which aims to:
 

• reduce any potential risk to your baby’s growth
• avoid premature birth if you become unwell
   

National maternity guidance from Public Health England > advises anyone who is pregnant to take extra care against the spread of coronavirus, which includes stricter social distancing and working from home where possible.

Appointments, scans and labour

You must attend your hospital appointments alone in order to minimise risks to yourself, your families and staff. This includes:
 

• ultrasound scans
• glucose tolerance tests (GTT)
• day assessment unit appointments
• antenatal clinic appointments
   

You should prepare two birth partners, so in the event of a birth partner needing to self isolate, you can ask your second birth partner to come with you (as long as they are symptom free).

Breastfeeding

If you have symptoms of coronavirus, we advise that the benefits of breastfeeding outweigh any potential risks of transmission of the virus through breast milk.

However, you should take the following precautions:
 

• wash your hands before you touch your baby, your breast pump or any bottles
• avoid coughing or sneezing on your baby while you breastfeed
• clean your breast pump after every use
• wear a face mask while you breastfeed, if you have one
   

Whatever method of feeding, consider asking someone who is well to feed your baby. If you are breastfeeding, you can express your milk so someone else can bottle feed.

Your baby’s movements matter

If you notice that your baby is not moving or the movements have changed or reduced, you still need to call the hospital you are booked to give birth at immediately. Even if you think you may have COVID 19 symptoms you must contact the hospital and we will arrange for you to be seen in an isolation area to check you and your baby are healthy. Do not wait for your next midwife appointment.

If you develop symptoms of coronavirus, you should call NHS 111 and follow national Coronavirus guidance >.

Treatment

You should continue your immunosuppressive medication, including steroids, unless instructed otherwise by your clinician.

If you stop taking your medication, it could cause a flare up of your condition which could increase your risk of complications if you get coronavirus.

It is advisable to avoid using anti-inflammatory medications, like ibuprofen, to treat symptoms of possible coronavirus. If you have been taking these types of medications to treat a long term condition, there is no need to stop them if you remain well.

Intraveneous (IV) treatment

Your immunosuppressive treatment will continue, even if you are practicing social distancing, including:

• Infliximab
• Vedolizumab
• Ustekinumab
• Tocilizimab
• Abatacept

If you have viral symptoms, such as a continuous cough or high temperature, please contact NHS 111.

In cases where an infection of any kind is confirmed, it may be necessary to stop your immunosuppressive treatment for a time.

Risk from coronavirus

Current national advice for people at high risk > considers patients on immunosuppressive therapy at increased risk from coronavirus, and steps should be taken to isolate as much as possible and work from home.

People who live with you should continue to practice good hand hygiene and safe social distancing.

Unless we have contacted you to cancel or rearrange your appointment, please attend as planned. Where possible, we may be able to offer you a phone call or digital appointment instead. If this is the case, we will let you know by phone or by post in advance.

You must not attend your appointment if you should be self-isolating because you, or somebody close to you, has, or has had, symptoms.

• Follow the NHS self-isolation advice >

• If you have a new and persistent cough, a fever (37.8 degrees or higher), or lose your sense of smell or taste, self-isolate to protect others and stop the spread.
• Do not visit your pharmacy, GP surgery or hospital.
• If your symptoms worsen during home isolation, use NHS 111 online or call NHS 111.
• Regularly wash your hands with soap and water.

If you have symptoms of coronavirus

• Do not book an appointment or visit a GP surgery or hospital.
• Follow specific public health advice and use NHS 111 online if your symptoms worsen.

All other patients

• Contact your GP surgery if you need medical help.
• Continue to attend appointments, unless you are contacted directly to advise otherwise, or if you have symptoms that require you to self-isolate.
• If you are unable to attend an appointment due to self-isolation, you should contact the hospital through usual routes for advice on what to do.
• If you have not been contacted directly by the team that manages your care to make any other arrangements at this point, you should plan to attend as normal.

You do not need to contact 111 to tell them you are staying at home. Use the NHS 111 online coronavirus service if:

• you feel you cannot cope with your symptoms at home
• your condition gets worse
• your symptoms do not get better after 7 days

Only call 111 if you cannot get help online. Always follow the NHS self-isolation guidance >.

Everyone is being reminded to follow Public Health England advice to:

• Always carry tissues with you and use them to catch your cough or sneeze. Then bin the tissue, and wash your hands, or use a sanitiser gel.

• Wash your hands often with soap and water, especially after using public transport. Use a sanitiser gel if soap and water are not available.
• Avoid touching your eyes, nose and mouth with unwashed hands.
• Avoid close contact with people who are unwell.