Currently all people who were previously considered clinically extremely vulnerable (CEV) will not be advised to shield in the future. No specific national guidance will be provided.

On 28th September 2021, the government updated guidance on protecting people who were previously considered as clinically extremely vulnerable from Covid-19 and the link is below.

https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

All homecare providers have already put in place practices to support all patients and especially those who were identified as clinically extremely vulnerable. You can be assured that there are no current plans to change the way homecare services support and protect you at this time. This means your drivers and nurses will continue to support you as if restrictions were still in place. This means that drivers and nurses will:

• continue to respect social distancing measures
• nurses will continue to wear Personal Protective Equipment (PPE) which includes face mask, gloves and aprons and use hand sanitisers.
• The driver will use hand sanitisers and, if needed, PPE to protect themselves and others if they are required to enter your home.
• Please note: nurses may need to ask to use your bathroom if on a long visit or having travelled on a long journey. Rest assured they carry disinfectant wipes to clean after themselves to keep patients safe so please allow them to use your facilities.
• During nurse visits the nurse may need to have a drink. They will keep socially distance from you as they may have to remove their mask to have a drink. This is important to ensure they remain hydrated. They will keep a safe distance from you so please allow them to do this. Thank you.

Please be sure to inform your homecare provider that you were previously on the list of extremely clinically vulnerable patients or if indeed due to your individual circumstances you have been advised that you are high risk and should taking additional precautions. Your homecare provider can reassure you and discuss with you any additional measure they can put in place to support you.

In order to keep up to date with news you may also find this website of help.

https://www.gov.uk/coronavirus 

Your homecare provider and clinical team understand that life is returning to normal for you and we are all faced with change. If your delivery or nurse visit is not convenient for you due to work commitments etc then please do help the homecare teams by contacting them and giving them as much notice as possible, in order that they can do their best to try to accommodate a change in appointment for you. Where a two-hour window delivery slot is normal practice, this will continue. We know you value your homecare service and we thank you for working with us so we can continue to provide you with the care and support you require.

Your clinical teams at the hospital are also returning to normal and if you have a clinic appointment it is very important you attend. If you are not able to attend then please do contact them as early as possible as this valuable appointment may be re-allocated to another patient. Thank you.

Please remember, whilst across the UK restrictions are lifted if visiting a healthcare setting then NHS patients, staff and visitors must continue to wear face coverings in England.

Further information can be found by clicking on the link below.

Infection Prevention Control (IPC) guidance advises that patients and visitors across all healthcare settings should wear a face covering, providing it is tolerated and is not detrimental to their medical or care needs. They should also be worn in care homes to protect residents from the risk of infection.

In Wales and Scotland face masks will still be mandatory in some public settings while Covid-19 remains an active.

Wales: https://gov.wales/face-coverings-guidance-public

Scotland: https://www.gov.scot/publications/coronavirus-covid-19-public-use-of-face-coverings/ 

We will still only enter your home if it is really necessary. Drivers have been trained in hygiene protocols to ensure your service continues as normal and there are no plans to change this currently. If the driver needs to enter your home, they will try to avoid touching you or others and surfaces. The driver will also be using hand sanitisers. This is normal practice to protect everyone. However, if you or anyone else in your household bubble have Covid symptoms or have been advised to self-isolate you must notify your homecare provider in advance of the delivery so appropriate precautions can be put in place to protect all. You will have been notified about any additional precautions if you have notified your homecare provider before the delivery is due to take place. If you have not had time to notify the homecare provider in advance, the driver will do their best to continue with your delivery but you must follow the driver’s instructions. If the driver is not able to complete your delivery, your homecare team will contact you to rearrange the delivery.

Currently all people who were previously considered clinically extremely vulnerable (CEV) will not be advised to shield in the future.

On 28th September 2021 the government issued guidance on protecting people who were previously considered as clinically vulnerable from Covid-19 and the link is below.

Homecare providers understand many patients receiving homecare services fall into high risk groups so all homecare services are designed to provide appropriate protection for all homecare patients and staff. Please be sure to inform your homecare provider that you have special circumstances that mean you are particularly high risk so they can reassure you and discuss what additional measures they can put in place to protect you.

The following information is available issued by the respective Government administrations;

• Patients living in England (https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19)
• Patients in Wales https://gov.wales/people-increased-risk-coronavirus
• Patients in Scotland https://www.mygov.scot/covid-highest-risk
• Patients in N.Ireland https://www.nidirect.gov.uk/articles/coronavirus-covid-19-guidance-clinically-extremely-vulnerable-and-vulnerable-people

Personal Protective Equipment normally describes the use of gloves, plastic apron and a facemask. All homecare drivers and nurses will be working to keep their hands clean by regular use of hand sanitiser and will be washing their hands often with soap and water. Homecare providers understand many patients receiving homecare nursing service will fall into high risk groups.

PPE is being used in accordance with the government guidance.

There is no general requirement for a homecare driver to use PPE providing social distancing rules are followed. Therefore, If it is a doorstep delivery no PPE will be required. However if the driver has to enter your home on your request then the driver will apply mask / gloves / apron and following the visit these items will be placed in a double bag and left double-bagged on the patients doorstep for normal household disposal.

• Homecare nurses will wear PPE appropriate to the homecare service and as recommended in the government guidelines.
• Medical grade face masks will not normally be provided for patients to wear but patients are encouraged to provide and wear their own face covering.

Government advice about the types of COVID vaccine and vaccination programme is available here. Some general information about suitability of COVID vaccinations in patient on different therapies may be available from your Patient Support Group. There is government advice on what to expect after your COVID vaccination here. If you have questions about the suitability of the COVID vaccinations for you personally, ask your G.P. or your hospital clinical team.

Covid-19 and flu vaccinations are not currently available through homecare services. To receive the Covid-19 vaccination at the earliest opportunity, you must respond to NHS communications about your Covid-19 vaccination. Further information on the priorities within vaccination programme and who to contact is available here.

https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/

https://www.gov.uk/government/publications/third-primary-covid-19-vaccine-dose-for-people-who-are-immunosuppressed-jcvi-advice. 

Vaccinations for homecare staff are being arranged via the NHS vaccination programme at the appropriate time in line with NHS guidelines for staff to ensure NHS healthcare services can continue. Many frontline homecare staff have already received their second dose of the Covid-19 vaccine and will receive the third dose of Covid-19 vaccine at the appropriate time. This includes homecare nurses and homecare drivers specialising in “over the threshold” deliveries who visit you at home.

Homecare staff not included in the NHS vaccination programme will receive their vaccination in line with Government guidelines in priority order. Further information on the priorities within vaccination programme is available here.

Covid-19 booster vaccinations (third doses) are being offered to all homecare provider staff in line with guidelines. All staff will be invited to arrange their booster doses at least 180 days following their second vaccination. More information can be found in the link below

https://www.gov.uk/government/publications/jcvi-statement-september-2021-covid-19-booster-vaccine-programme-for-winter-2021-to-2022/jcvi-statement-regarding-a-covid-19-booster-vaccine-programme-for-winter-2021-to-2022

There is no change to homecare services in this respect. Please continue to respect social distancing and follow any instruction from homecare staff. Where appropriate, homecare staff will wear PPE if social distancing cannot be maintained when they visit you at home.

You can be reassured that the safety of homecare patients remains a key priority for all clinical homecare providers. We continue to follow relevant NHS guidance to keep you as safe as possible and minimise the risk of cross infection.
All homecare companies are bound by employer and patient confidentiality, which will be respected at all times, so we will not be able to answer questions about specific members of staff or other patients. If something has happened that is a significant risk to your wellbeing, please be assured that we will inform you.

The homecare services are currently operating as normal. However, if any delays are expected your homecare provider will contact you to discuss this as normal. As restrictions have lifted some homecare providers are experiencing difficulties in contacting patients so please remember if you receive a missed call or an email from your homecare provider please do contact them as soon as possible. This will prevent the need for emergency deliveries which can be challenging and costly. Thank you for your supporting your homecare team.

You should notify your homecare company that you are in self-isolation or quarantine if you are due a delivery during this period. Do not worry your medicines will be delivered to you. The driver will wait more than 2m away until the door is answered. Once the door is answered the delivery driver will ask the normal delivery questions and it will be the driver who will sign to state they have witnessed the delivery being accepted. The driver will use hand sanitisers and, if needed, PPE to protect themselves and others they visit.

There are currently no plans to change practices adopted by your homecare provider.
Until further notice, medicine deliveries will not need to be signed for. Your delivery driver will wait more than 2m away until the door is answered. Once the door is answered the delivery driver will ask the normal delivery questions and it will be the driver who will sign to state they have witnessed the delivery being accepted. All drivers will use hand sanitisers to protect you and others.

Homecare nurses are visiting patients according to their treatment plan and are wearing PPE to protect you, themselves and others. Current working practice of nurses wearing PPE has not changed and will continue. If you or anyone in your household bubble have Covid-19 symptoms or have been advised to self-isolate you must notify your homecare provider. The homecare providers clinical team will follow guidance from your NHS clinical team. You will be advised about the arrangements that will be put in place if there is any change to your treatment plan.

Covid-19 can make anyone seriously ill. But for some people, the risk is higher. People are no longer being called clinically extremely vulnerable. However, some people who were previously considered clinically extremely vulnerable are still considered at high risk of Covid-19.

Homecare providers understand many patients receiving homecare services fall into high risk groups so all homecare services are designed to provide appropriate protection for all homecare patients and staff. Please be sure to inform your homecare provider that you have special circumstances that mean you are particularly high risk so they can reassure you and discuss what additional measures they can put in place to protect you.

The following information is available issued by the respective Government administrations;

• Patients living in England (https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19)
• Patients in Wales https://gov.wales/people-increased-risk-coronavirus
• Patients in Scotland https://www.mygov.scot/covid-highest-risk
  Patients in N.Ireland https://www.nidirect.gov.uk/articles/coronavirus-covid-19-guidance-clinically-extremely-vulnerable-and-vulnerable-people

All Homecare companies remain aware of the current guidance and ensure they are aware of any changes implemented across the UK, whether at National or local level. The practices that have been put in place to safeguard patients / carers and all staff are in accordance with government recommendations. Social distancing rules will continue to be followed across the UK and we will seek to ensure you are provided with your Medicines Homecare Service as normal. Rest assured that Homecare providers are permitted to travel into local lockdown areas in order to provide continuity of your services.

The safety of homecare patients remains a key priority for all clinical homecare providers and that is why with the lifting of restrictions we continue to operate appropriate working practices to keep you safe. We continue to follow relevant government guidance. Homecare services are following guidance from the NHS which minimises the risk of cross infection.
Homecare nurses are being offered the Covid vaccine as a priority and are included in the Covid testing programmes for healthcare staff. All homecare drivers and nurses are required to self-isolate if they know they have been exposed to risk of Covid infection.

The government guidance is that patients must wear a face covering when visiting hospital see below link.

https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own

The advice relating to healthcare delivered in the home has not changed, however, we would encourage you to wear your own face covering during a nurse visit. We understand this might not be possible due for example breathing difficulties, please be assured that the visit and treatment will continue.

Homecare Providers are ready to support the NHS COVID response in any way we can. You can rest assured that all homecare providers will not take on new services unless they are able to continue to provide existing services. So, it is not expected that the quality of your service will be impacted by your homecare provider taking on new services.

All homecare companies are experiencing a very high number of calls and emails and it may take you longer than normal to get through to them. Please look at your homecare companies’ website for details on the best way to contact them. Also refer to any information they have sent you.

We are very sorry your homecare services have not met your expectation. Currently homecare services are also under pressure as additional patients are commencing on homecare services to prevent hospital attendance. You can rest assured that we are doing are very best to enable all patients to receive their treatment as planned.
We are aware that all homecare service providers are experiencing a very high call volume currently. This may result in delays in answering your calls at this time. Please be aware that this is being monitored by your homecare provider.

In the first instance you should always discuss your concerns with you Homecare providers Customer Services Team, you can find how to contact your homecare company by visiting their website. They will be very keen to support you and take the issue your raise seriously. Your homecare provider is responsible for doing their best to provide you with a response to your concern. You may also wish to raise your concerns with your clinical team at your hospital.

However, should you require further information the following may assist:

For complaints in UK: Including England and Wales
www.nhs.uk/using-the-nhs/about-the-nhs/how-to-complain-to-the-nhs/
www.cqc.org.uk/contact-us/how-complain/complain-about-service-or-provider
www.ombudsman.org.uk/make-a-complaint

For complaints in Scotland contact:
www.mygov.scot/nhs-complaints/
https://www.careinspectorate.com/index.php/complaints
Care Inspectorate, Compass House, 11 Riverside Drive, Dundee DD1 4NY
Or call tel. 01382 207 100 or 0345 600 9527
You can also email: enquires @careinspectorate.com

For complaints in Northern Ireland:
www.nidirect.gov.uk/articles/raising-concern-or-making-complaint-about-health-services
The Regulation & Quality Improvement Authority, 9th Floor Riverside Tower, 5 Lanyon Place, Belfast BT1 3BT
Or call tel. 02890 517 500
You can also email: info@rqia.org.uk

For complaints in Wales:
www.careinspectorate.wales/contact-us/raise-concern
Tel: 0300 7900 126
NHS 111 Wales – Contact Us : Putting Things Rights: Raising your Compliments and Concerns
Care Inspectorate Wales: – Telephone: 0300 7900 126
Email: ciw@gov.wales
Welsh Government office
Sarn Mynach
Llandudno Junction
LL31 9RZ

This will depend on the reason you are unsure about taking your medication. If you have concerns regarding continuing to take your regular medication you should speak to your hospital clinical team.

At this time the NHS are experiencing high levels of demand therefore it may take NHS teams longer to respond to messages and telephone helplines than normal. You may have also received a letter from your hospital providing guidance on how to contact your clinical team so refer to the guidance in any letter received from your clinical team, if this has been sent to you.
In addition, please remember to contact your clinical team / GP if you cannot find the information you require from Government websites and the information or advice you require is essential.
However, if you have an urgent medical problem and you’re not sure what to do you can get help from NHS 111 as follows:
Seek help online or on the phone, try online first if possible.

To get help from NHS 111, you can:

• go to 111.nhs.uk (for people aged 5 and over only)
• call 111

NHS 111 is available 24 hours a day, 7 days a week.

Information:
If you’re Deaf and want to use the phone service, you can use the NHS 111 British Sign Language service available in your country:

• England – NHS 111 (BSL) interpreter service
• Scotland – NHS 24 111
• Wales – NHS 111 Wales
• Northern Ireland – NHS 111 Northern Ireland

You can also call 18001 111 on a textphone.

If you have a genuine Life-threatening Emergency call 999. Medical emergencies can include:

• loss of consciousness
• an acute confused state
• fits that aren’t stopping
• chest pain
• breathing difficulties
• severe bleeding that can’t be stopped
• severe allergic reactions
• severe burns or scalds

Call 999 immediately if you or someone else is having a heart attack or stroke. Every second counts with these conditions. Also call 999 if you think someone has had a major trauma, such as after a serious road traffic accident, a stabbing, a shooting, a fall from height, or a serious head injury.

Additional information is available about calling 999 here: via this website link
https://www.nhs.uk/using-the-nhs/nhs-services/urgent-and-emergency-care/when-to-call-999/

It is understandable that you may have concerns. However, the Pharmaceutical Companies having been planning for EU exit (Brexit) and have been working with your homecare providers to ensure your homecare services can continue as normal. You can be assured that your homecare provider will be in touch with you if any issues arise. At this stage there should be no cause for concern and your medications should be delivered as planned.