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Service Delivery during the Coronavirus (COVID-19) outbreak

The scale of the COVID19 outbreak in the United Kingdom is becoming apparent. It is a fast changing situation but it is becoming clear that the National Health Service, including NHS Lanarkshire, will need to change how it delivers some of its usual services.

These changes will be necessary to reduce the risk of our patients contracting the virus and will free up our medical and nursing staff to help with NHS Lanarkshire’s response to the outbreak. We hope that these changes will be temporary and aim to return to our normal services once it is clear that the outbreak is clearing.

If you have an appointment booked in the next few weeks you may receive (or have already received) a notification that this appointment has been cancelled. If your appointment is cancelled you will be given another appointment, but this may be some time in the future.

It is also likely that other services will be disrupted. Please be assured that services will still be available to try and support you in the management of your condition.

Rheumatology

Advice about Coronoavirus and COVID19

Rheumatology Helpline: 01355 585691

Contacting the Rheumatology Department

During the COVID19 outbreak we will still try to support you in the management of your condition.

If your rheumatic disease gets worse (‘flares up’) members of the rheumatology department will still be available to help you. However, please bear with us, it may take us longer than usual to respond and we will prioritise situations where help appears urgently needed.

We may also not be able to help with situations that are not directly linked to your rheumatic disease or its treatment.

If you are concerned that your rheumatic disease is getting worse please contact the Rheumatology Helpline on: 01355 585691.

If there is no reply please leave a message with your name, CHI number (if you know it) or date of birth, your telephone number and a brief description of your problem. A member of the department will then contact you to gather some more information.

If possible, we will try to help with your condition over the telephone; however, if it is not possible to help over the telephone we will try to arrange to see you at an outpatient clinic. Please note, this appointment may not be with your usual doctor, or at your usual hospital, but the member of staff who sees you will have been able to review your medical notes before they see you.

In some cases, we may refer you directly to our colleagues in Physiotherapy, Podiatry or Occupational Therapy to see if they can help with your problem.

Once our clinics are running normally again, we hope that you will be able to start attending your usual hospital again with your usual rheumatology team.

If you have a question about the arrangements for your clinic appointment please contact the rheumatology secretaries at your usual rheumatology department

Reducing your risk of contracting COVID19

We strongly encourage all of our patients to follow the most up to date Government and NHS advice about what measures to follow to reduce their risk of contracting the virus or passing it on to others. The following advice is subject to change and the most up to date advice will be available on the NHS Inform, Health Protection Scotland and NHS Lanarkshire websites.

  1. Follow current Government advice about social distancing, avoiding large groups, avoiding unnecessary social contact and (where possible) working from home
  2. Avoid contact with anyone who is unwell, particularly if they have symptoms of a cold or flu or symptoms that are suggestive of COVID19 (such as a cough, breathlessness or fever)
  3. Regularly washing your hands with warm water and soap for at least 20 seconds each time and avoid touching your face with unwashed hands. If soap is not available use hand sanitizer and allow it to dry for at least 10 seconds
  4. Regularly disinfect your home and work surfaces
  5. Capture coughs and sneezes in a disposable tissue and disposing of this promptly. If you don’t have a tissue cough into your sleeve
Implications for Rheumatic Disease Treatment

If you are well, current guidelines suggest that you should continue to take your rheumatic disease treatment as usual to reduce the risk of your condition flaring. Everyone should strictly follow the current advice about how to reduce your risk of catching COVID19.

However, if you are currently taking immunosuppressive therapy (listed below) we also strongly recommend that you strictly socially distance yourself by remaining at home, not going to work and refrain from social contact.

The advice about undertaking full social isolation applies if you are currently prescribed, or have recently received, any of the following therapies:

  • Abatacept
  • Adalumimab
  • Anakinra
  • Apremilast
  • Azathioprine
  • Baracitinib
  • Certoluzimab
  • Ciclosporin
  • Cyclophosphamide
  • Etanercept
  • Golimumab
  • Infliximab
  • Ixekuzimab
  • Leflunomide
  • Methotrexate
  • Methylprednisolone
  • Mofetil (or Mycophenolic acid)
  • Mycophenolate
  • Prednisolone – doses greater than 7mg/day
  • Rituximab
  • Sarilumimab
  • Secukinumab
  • Tacrolimus
  • Tociluzimab
  • Tofacitinib
  • Ustekinumab

At present, patients who are prescribed the following milder immune therapies do not need to consider full social isolation, but should follow all of the other general precautions: Gold (Myocrisin), Hydroxychloroquine, Penicillamine or Sulphasalazine

If you think you are developing any of the symptoms of COVID19, such as a continuous cough, fever or breathing difficulties, you should not take any further doses of your rheumatic disease therapy and consult the NHS Inform website for the latest advice on what to do next.

Please note, if you are currently prescribed steroid therapies (such as prednisolone, hydrocortisone or dexamethasone) these should not be stopped abruptly even if you feel unwell

Non-Steroidal Anti-Inflammatory Drugs

There has been some attention in the press about NSAIDs, such as ibuprofen and naproxen. There is currently no strong evidence that ibuprofen can make COVID19 worse. However, until more information is available take paracetamol to treat the symptoms of COVID19, unless you have been informed that you can’t take paracetamol.

If you are already prescribed a NSAID (see list below) on the advice of a doctor, do not stop taking it without checking first. Drugs that are NSAIDS include: ibuprofen, naproxen, diclofenac, etodolac (Lodine), etoricoxib (Arcoxia), celecoxib (Celebrex), meloxicam

General advice about COVID19

Additional sources of advice about COVID-19 for people with rheumatic diseases

Near Me Lanarkshire