Due to the unprecented measures the nation is taking to tackle the novel coronavirus, GP surgeries across the nation have had to make changes to how we operate. We thank you for your support and understanding during this time.

Below are common questions our community might have:

Why is Castle Surgery not operating normally?

• Due to the coronavirus pandemic, we have been advised to suspend all routine services and are currently operating in a new way to provide healthcare services to our patients.
• This is to reduce the risk of spreading the novel coronavirus whilst protecting our staff and patients.

Should I be self-isolating and/or social-distancing?

• Please follow the Public Health Guidance (https://phw.wales.nhs.uk) and Welsh Government advice (https://gov.wales/coronavirus).
• Only go outside for essential food, exercise reasons or if you are a key worker (if you cannot work from home).
• If you do have to go outside ensure that you maintain a 2-metre distance (6ft) from other people at all times

I believe I am very high risk but have not received my shielding letter

• Patients identified as being very high risk of severe illness from coronavirus (due to serious underlying condition(s) will receive a letter from the Chief Medical Officer for Wales by the 03.04.2020. This letter is not being issued by GP surgeries, so please do not contact the practice to ask about these letters.
• The letter will advise people to stay at home for 12 weeks and contains a range of further information and advice, including those who have nobody else to support them, how they can get medication and other essential items including food. The published information is already available on the Welsh Government website (gov.wales/get-coronavirussupport-extremely-vulnerable-person)
• If another member of the household receives a shielding letter from the CMO and you are in employment or a key worker, you will need to discuss this directly with your employer to see if any reasonable adjustments can be made to your employment – for example home working.
• If you work for the NHS, please contact HR/Occupational Health

What is the current guidance on shielding?

Please check the government guidelines here:

Advice shared by local trust suggests:

The only group that are recommended to shield by Government advice is:

You are taking ALL THREE OF:

• a steroid preventer inhaler (at any dose)

• 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)

• 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.

 

What should I do if I believe that I have symptoms of coronavirus?

• GP surgeries cannot determine if your cough, cold or fever is caused by the coronavirus as we cannot undertake any testing.
• You can use the NHS Direct Wales Self Symptom Checker
  (nhsdirect.wales.nhs.uk/SelfAssessments/symptomcheckers/COVID19.aspx)
• You need to follow Public Wales / Government advice and self-isolate if you have symptoms.
• Do not attend the surgery, pharmacy or local hospital.

When should I contact 111?

• If you feel you cannot cope with your COVID19 symptoms at home.
• If your symptoms do not improve after 7 days.
• Use the online NHS Direct Wales Website (nhsdirect.wales.nhs.uk) first before calling 111 as most information can be found here regarding COVID19.
• Obtain a self-isolation fit/sick note (111.nhs.uk/isolation-note).

Am I still OK to take Ibuprofen?

• Unless you have been told previously before the outbreak that you should avoid ibuprofen for certain medical reasons, current guidelines according to UK government website, updated as of 20th March 2020, states

There is currently no strong evidence that ibuprofen can make coronavirus (COVID-19) worse.

We are aware there has been concern spreading about the use of ibuprofen and other non-steroidal anti-inflammatory medications (NSAIDs) in relation to COVID-19.

However, there is currently no research into ibuprofen and the new coronavirus.

gov.uk/government/news/ibuprofen-use-and-covid19coronavirus

What do I need to do now if I need to see a clinician urgently?

• We operate a telephone full triage service which means your details and problem will be taken by a receptionist and a clinician will ring you back as soon as they can.
• This will not be immediately, so please ensure that you are near your home phone, or have your mobile phone with you.
• As part of your call the receptionist will take details and ask relevant questions about why you need to speak to a clinician, often you may not need to speak to a clinician and the receptionist will be able to signpost you to relevant services or our website for information on self-care.
• A clinician will contact you and usually make a telephone assessment as most concerns can be dealt with over the phone very quickly.
• A clinician may deem it appropriate to hold a video consultation in which case you will receive a text message from the clinician advising you to participate in a video consultation which will include instructions on what to do.

If the clinician feels you need an assessment in the surgery, special arrangements will be made for you to attend. Please only attend with one accompanying adult when necessary.

If I am offered a Video Consultation what should I do?

• Please see this link: castlesurgery.com/video-consultations-at-castle-surgery/
• Please endeavor to follow the instructions within the text message within 2-3 minutes of receiving the message. This will ensure your video-consultation runs smoothly and avoids you missing your allocated consultation slot.
• A smartphone/tablet with a camera is needed as well as good Wi-Fi or 4/5G data signal.
• Please be aware of any data limits. Switch to WiFi with unlimited data limits if possible.
• If you consent to engage with a video consult, the clinician may not always require this and may choose to use a regular telephone call.

My problem is not that urgent, but I need some help what should I do?

• Please visit our website and click on the self-care option which is on our main landing page.
• On the self-care pages you will find a lot of information, guidance and videos which will help you understand self-care and what to do. This may prevent the need for you to seek a telephone appointment.

What about home visits?

• Home visits are suspended except for exceptional circumstances, in order to reduce the risks to our most vulnerable patients.

What about blood tests?

• We will provide a small number of urgent blood test clinics in the week and these will be for absolutely essential blood tests such as INR.
• All routine blood tests have been suspended such as annual bloods, cholesterol etc. and will resume after the coronavirus pandemic.

Will I still have my annual check-up for asthma, COPD, diabetes etc.?

• These routine checks have been suspended until after the pandemic. However in many situations our nursing team will endeavour to undertake reviews via telephone/video consultation.

I have COPD/Asthma do I need a ‘rescue pack’ for COVID-19?

• ‘Rescue packs’ containing oral steroids and antibiotics are sometimes prescribed for
  patients with COPD or asthma, to keep at home and use as part of a personal asthma or COPD management plan when experiencing an exacerbation.
• Rescue packs should only be used in those people who have previously been prescribed them to manage exacerbations as part of their agreed COPD or asthma management plan.
• Inappropriate requests for unnecessary medication could lead to supply problems for patients who genuinely require these medicines, and divert valuable time and resources from patients most in need.

What should I do if I am due a medication review?

• We are prioritising medication reviews to ensure your medication can be safely re-issued.
• If a review of your medication is due our clinical pharmacist or another clinician will contact you beforehand to discuss necessary monitoring.
•  If you have not had a medication review we will continue to issue medication as normal, so please do not worry.

How do we pick up prescriptions?

• Information about how to get your prescriptions available at this link

Can I still get my repeat prescription?

• Yes, please visit our website and click on the online services button. You can request your repeat prescription online without visiting the surgery.
• You can nominate a preferred pharmacy. Your prescription will then be sent to your
  nominated pharmacy without the need to visit the surgery. In most cases your local
  pharmacy can manage your repeats prescriptions for you, but you will need to speak to them directly about this.
• During the current pandemic we will be issuing 2 months post-dated prescriptions where it is deemed safe.

How do I obtain my test results?

• The easiest way to obtain your test results if they are outstanding is to visit our webpage click on the online services button, click discuss test results and complete the form.
• The GP will contact you to discuss your results.

What if I need a fit/sick note?

• The GPs cannot provide fit/sick notes for coronavirus/self-isolation/social
  distancing/shielding. This is a government decision not to put pressure on general practice.
• Your employer is not allowed to insist on a Doctors certificate. Please use the 111 selfisolation website (https://111.nhs.uk/isolation-note)
• If you have been on a long term fit/sick note and it has run out, please use the online services section of our website and request an extension. We will then email this back to you rather than you collecting it from the surgery

Can I still have a joint injection?

• At present, we have suspended all joint injections until after the pandemic.

My contraception or HRT is due bit it is no longer on my repeat list?

• In most cases, we will issue repeat prescriptions without a face-to-face consultation to keep you going until after the pandemic.
• We will aim to keep administering Depo-Provera injections to existing users, but have suspended all coil fittings.

Is it safe to delay my B12 injections?

• There is existing guidance that we have issued regarding this which has been agreed by the Local Health Board and other practices within our cluster area.
• Whilst we understand there is a lot of concern about risk to patient health if their schedule of B12 injections is disrupted. We have been provided reassurance from the Consultant Haematologist that this is not the case in the short to medium term. Therefore postponement of B12 injections during COVID-19 pandemic is the responsible measure to reduce patient exposure in community and at the
  surgery.
• In the meantime, The British Society of Haematology guidelines support switching intramuscular B12 injections following loading regime to daily oral cyanocobalamin 1mg.
  • It is recognised many patients feel many benefits from the injections, but even severe pernicious anaemia requires only 3 monthly injections if not taking oral supplements, oral B12 is available in pharmacies as over the counter medication.

What about immunisations?

• We aim to continue immunisations for babies, young children and pregnant women
  following the guidance issued by Welsh Government. You will need to be well and have no
  symptoms of COVID19.
• We have suspended all travel vaccines.

Can I see the midwife if I am Pregnant?

• If you are newly pregnant, contact the surgery for a pregnancy pack and complete the pregnancy form. The midwife will then call you at approximately 9 weeks to arrange your 12
  week scan.
• If you are less than 28 weeks, routine checks are not necessary.
• If you are over 28 weeks pregnant, your midwife will contact you to arrange your antenatal
  checks.
• If you have any concerns, please contact the Community Midwifery Team  

What is happening with wound dressings?

• We are trying to provide wound dressing services where we can. Please contact the
  surgery for an appointment.
• Currently the Practice Nurse or Healthcare Assistant where possible are teaching many patients or family members to dress wounds in case they are self-isolating or
  coronavirus affects our nursing resources.

I am asthmatic, what should I do?

• If you have been prescribed a preventative inhaler, ensure that you take the regularly from now on. Taking your preventer inhaler everyday will greatly reduce the risk of complications
• Please visit https://www.asthma.org.uk/ for advice and guidance.
• This is a very challenging and unprecedented time for everyone. We can assure you that the practice is taking all the necessary steps to ensure the safety of all our patients and staff. 

I want to discuss an advanced care plan, how can I do that?

• Please phone and ask for a GP call-back
• An Advance Care Plan is a written statement that sets out your wishes, beliefs, values and preferences about your future care.
• It provides a guide to help healthcare professionals and anyone else who might have to make decisions about your care if you become too unwell, to make decisions or to communicate them.
• Read more about the concept of Advanced Care Planning here