Accessing health services

Am I at risk?

People living with existing health conditions are more at risk from coronavirus than others.

There are some conditions that put people at particularly high risk. These people should have received a letter from the NHS advising them what to do. They include:

• people who've received solid organ transplants
• people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD
• people with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell)
• people on immunosuppression therapies which significantly increase the risk of infection
• women who are pregnant with significant heart disease, congenital or acquired
• people with cancer who are undergoing active chemotherapy
• people undergoing radical radiotherapy for lung cancer
• 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
• people with kidney disease.

How can I stay safe?

If you have one of the conditions listed above, you are advised to shield. You should try to stay inside as much as possible but, under new guidance, can go outside in open spaces with members of your household or, if you live alone, with one person outside of your household.

If you are not considered 'extremely clinically vulnerable' you can leave home for the following reasons:

• For work, where you cannot work from home. If this applies to you then you should travel to work by car, foot, or bike if possible. If you need to use public transport, try to travel at non-peak times when it should be less crowded.
• To go to shops that are allowed to be open to buy things like food and medicine or to collect items you have ordered over the phone or online.
• For unlimited leisure and recreation outside, which includes doing exercise, sitting, or playing sports with members of your household.You can meet outdoors with up to 5 people from outside your household including in private gardens. It is essential that you maintain social distancing measures whilst seeing friends and family and stay 2 metres away from anyone outside your household. You should not go in to anyone else’s house unless you are accessing their garden or using the toilet.
• 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.
• To attend the funeral of a close family member or member of your household.
• To access critical public services, such as social services, support services for victims, or services provided by the Department for Work and Pensions.

When you do leave your house, you need to stay at least 2 metres away from other people (except members of your own household).

What should I do if I'm unwell?

You may feel like you should avoid getting help for medical conditions because you’re worried about putting the NHS under additional pressure or be worried about catching the virus by going to a doctor’s surgery or hospital.

But your health needs are just as important as before and you should seek care and treatment that you need. The NHS has systems in place to ensure that essential care is still available for anyone who needs it and measures are in place to minimise the spread of the virus.

If you become unwell you can still speak to your GP, although they may do this over the phone rather than face-to-face.

If you have an existing health condition, you should continue to follow your treatment plan. If you have any concerns then contact their GP or specialist.

If you need urgent medical help, whether or not you have coronavirus symptoms, you should contact 111 or call 999 in an emergency.

Will my appointment or treatment be postponed?

Some medical appointments have been postponed or they may be delivered in a different way. This is to help stop the spread of coronavirus and to protect the NHS.

Outpatient appointments

There’s going to be some changes to outpatient appointments. Some people will be asked to have their appointment over the phone or by online video consultation. Other patients will find their appointment has been rearranged.

Patients who need to have their appointments face-to-face will be asked not to bring a friend or relative with them, unless completely necessary.

Cancer treatment and clinically urgent care

Cancer treatment and clinically urgent care will still be treated as a priority, but your treatment plan might be reviewed. They'll consider whether the risks of your treatment have changed as a result of coronavirus. Your clinical team will talk to you and answer questions you may have about any changes to your treatment or appointments.

Anyone who's worried they have signs or symptoms of cancer should contact their GP. Don't put off getting help as the earlier cancer is detected the better. 

Cancer Research and Macmillan have specific guidance on coronavirus for cancer patients. 

• Cancer Research's coronavirus information
• MacMillan's coronavirus information

Non-emergency operations

All non-emergency operations are being suspended for at least three months. This is to help keep patients safe and to make sure the NHS have the resources they need to tackle coronavirus. This will include hip and knee replacements, cataract surgery, as well as minor surgery.  We know lot of people will have already been waiting a long time for their treatment and this news might be upsetting and frustrating.

GP appointments

Your GP may postpone routine appointments, such as medicine reviews, check-ups and annual health checks, or try to hold appointments over the phone or on video chat. It’s important that you let your GP know if you have developed symptoms since your last check-up so they can decide if you need to be seen. Let your GP know right away if you develop any symptoms for other illnesses, such as cancer. 

If you have symptoms before an appointment

If you have symptoms of coronavirus, or a member of your household does, you should let your doctor or clinician know before attending your appointment. In most cases your appointment will be rearranged, however some people who are receiving life-saving treatment will be asked to still attend. If this is the case, your clinician will put in place extra precautions to keep you safe.

If you are shielding and need ongoing treatment or care

If you have health conditions which make you extremely vulnerable to coronavirus and have been advised to shield, then you should contact your GP or specialist for advice on how to continue receiving your care and treatment.

How will I get to my appointment?

Patient transport services are being used to transport people who have been discharged from hospital, which means they are under more pressure than usual.

To help ease this pressure, patients whose treatment is still going ahead are being asked to see if a friend, family, or household member can take them to their appointment. But they shouldn’t take you if they have symptoms of coronavirus or if you have symptoms.

Patient transport services are still available for certain patients, but the eligibility guidelines have changed. Priority is being given to:

• patients who are classed as extremely vulnerable from coronavirus and who need to attend ongoing care appointments or treatment but have no access to private travel
• patients suspected of having coronavirus who need to attend ongoing care appointments and have no access to private travel.
• patients with life-sustaining care needs who need to attend a care setting, such as for dialysis, and have no access to private travel.

Patient transport services will be taking additional precautions, including extra cleaning of vehicles and proportionate use of personal protective equipment (PPE) to make sure patients and staff can travel safely.

If you're unsure if you should still be attending your treatment, speak to your hospital clinician for advice.

What happens when I come out of hospital?

If you’re currently in hospital or are admitted as a result of coronavirus, there are a few things it's worth knowing about how the discharge process will work during the outbreak:

1. You and your family should have the current discharge process clearly explained to you as you're admitted to hospital. You should also be given a leaflet explaining this process.
2. You'll be reviewed regularly during your time in hospital and once it's agreed you no longer need to be in hospital, staff will explain the next steps they will follow so you can will be discharged quickly with the necessary support. You should be given a short leaflet explaining what to expect either if you can go home or should you need to move to another location for further care.
3. Once moved to the next agreed location – that may be back at home, into a community hospital or into a care home – you may then have a more detailed assessment.
4. The NHS will pay for any follow-on care that it's agreed that you need when discharged. This should be explained by staff, including how long this is likely to last and what happens next.

As part of plans to increase testing for coronavirus, the government announced its intention to test all residents before they move into a care home, starting with those moving to a care home after a hospital stay. If you are to move into a care home, discharge staff will explain how they are managing testing in your hospital

Can I visit someone in hospital?

To help stop the spread of coronavirus and keep patients safe, hospitals are no longer allowing most visitors.

There are some exceptions. If you are a carer or immediate family member you may be allowed to visit if:

• The person you are visiting is receiving end-of-life care that is not related to coronavirus.
• You are the birthing partner accompanying a woman in labour.
• You are a parent or appropriate adult visiting your child.
• You are supporting someone with a mental health issue such as dementia, a learning disability or autism, where not being present would cause the patient distress.

Even if you fall into these categories, you should contact the ward before visiting as hospitals will have the ultimate say over who is able to visit and will make a decision based on the risks to both the patient and the visitor.

If you do visit, you’ll be asked to take precautions. This will include making sure you wash your hands when entering and leaving the hospital. You should also go straight to the ward you’re visiting and not visit other areas of the hospital. 

There is specific guidance in place for people who wish to visit someone during the final days of their lives. When a person is expected to only live for 24-48 hours, the hospice, care home, or hospital they are in will try to ensure that a close family member or friend is able to be with them. This will be the case even if the person receiving end-of-life care has coronavirus. Only one visitor will usually be allowed but if social distancing is possible, then two people may be allowed to visit. The hospital, hospice, or care home where your loved one is staying will be able to advise you of what precautions you will need to take when visiting. They will also tell you how long you are able to visit for.

If you or someone in your household has symptoms of coronavirus, you should not visit a friend or relative in a hospital, hospice or care home. You should also consider any risks to your health before visiting someone. People who are classed as extremely vulnerable to coronavirus or who are immuno-compromised should not be visiting people at this time.

Not being able to visit a loved one is likely to be distressing. Try to find different ways to stay in touch such as over the phone or by video call. Even if they are unable to communicate with you, they may find hearing your voice comforting.

It is especially upsetting if you are unable to visit a loved one who is in the last days or weeks of their life. While you may not be able to be there in person, you could ask staff who are caring for your loved one to pass on messages, pictures or laminated photos. Marie Curie offer advice and a dedicated helpline for anyone going through this difficult time.