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Very High Risk COVID Patient Advice

Date: 14/4/20


IMPORTANT: PERSONAL                                                                                                                                                                                       



Dear Patient,





Your safety and the continued provision of the care and treatment you need is a

priority for the NHS. This letter gives you advice on how to protect yourself and

access the care and treatment you need.


The NHS has identified you, or the named person you care for, as someone at

risk of severe illness if you catch Coronavirus (also known as COVID-19). This

is because you have an underlying disease or health condition that means if you

catch the virus, you are more likely to be admitted to hospital than others.


The safest course of action is for you to stay at home at all times and avoid all

face-to-face contact for at least twelve weeks from today, except from carers

and healthcare workers who you must see as part of your medical care. This

will protect you by stopping you from coming into contact with the virus.


If you are in touch with friends, family or a support network in your community who

can support you to get food and medicine, follow the advice in this letter. If you do

not have contacts who can help support you go to, the Government’s dedicated website.


If, at any point, you think you have developed symptoms of coronavirus, such as a

new, continuous cough and/or high temperature (above 37.8 °C), seek clinical advice

using the NHS 111 online coronavirus service ( If you

do not have access to the internet, call NHS 111. Do this as soon as you get




You, or the person you care for, should:


• Strictly avoid contact with someone who is displaying symptoms of coronavirus

(COVID-19). These symptoms include high temperature (above 37.8 °C) and/or a

new and continuous cough.


• Not leave your home.


• Not attend any gatherings. This includes gatherings of friends and families in

Private spaces e.g. family homes, weddings and religious services


• Not go out for shopping, leisure or travel. When arranging food or medication

Deliveries, these should be left at the door to minimise contact


• keep in touch using remote technology such as phone, internet, and social media


• Use telephone or online services to contact your GP or other essential services


• Regularly wash your hands with soap and water for 20 seconds. Ask carers or

support workers who visit your home to do the same.



The rest of your household should support you to stay safe and stringently follow

guidance on social distancing, reducing their contact outside the home. In your

home, you should:


• Minimise the time you spend with others in shared spaces (kitchen, bathroom and

sitting areas) and keep shared spaces well ventilated


• Aim to keep 2 metres (3 steps) away from others and encourage them to sleep in

a different bed where possible


• Use separate towels and, if possible, use a separate bathroom from the rest of the

household, or clean the bathroom after every use


• Avoid using the kitchen when others are present, take your meals back to your

room to eat where possible, and ensure all kitchenware is cleaned thoroughly.


If the rest of your household are able to follow this guidance, there is no need for

them to take the full protective measures to keep you safe.


You will still get the medical care you need during this period. We are considering

alternative options for managing your care and will be in touch if any changes are

needed. Your hospital care team will be doing the same. We also advise that:


1. Carers and support workers who come to your home


Any essential carers or visitors who support you with your everyday needs can

continue to visit, unless they have any of the symptoms of coronavirus. All visitors

should wash their hands with soap and water for 20 seconds, on arrival and often.


It is also a good idea to speak to your carers about what happens if one of them

becomes unwell. If you need help with care but you’re not sure who to contact

please visit



2. Medicines that you routinely take]


The government is helping pharmacies to deliver prescriptions. Prescriptions will

continue to cover the same length of time as usual. If you do not currently have your

prescriptions collected or delivered, you can arrange this by:


1. Asking someone who can pick up your prescription from the local pharmacy,

(this is the best option, if possible);


2. Contacting your pharmacy to ask them to help you find a volunteer (who will

have been ID checked) or deliver it to you.

You may also need to arrange for collection or delivery of hospital specialist

medication that is prescribed to you by your hospital care team.


3. Planned GP practice appointments


Wherever possible, we will provide care by phone, email or online. But if we decide

you need to be seen in person, we will contact you to arrange your visit to the

surgery or a visit in your home.


4. Planned hospital appointments


NHS England have written to your hospital to ask them to review any ongoing care

that you have with them. It is possible that some clinics and appointments will be

cancelled or postponed. Your hospital or clinic will contact you if any changes need

to be made to your care or treatment. Otherwise you should assume your care or

treatment is taking place as planned. Please contact your hospital or clinic directly if

you have any questions about a specific appointment.


5. Support with daily living


Please discuss your daily needs during this period of staying at home with carers,

family, friends, neighbours or local community groups to see how they can support

you. If you do not have anyone who can help you, please visit


This letter is evidence, for your employer, to show that you cannot work outside the

home. You do not need to get a fit note from your GP. If you need help from the

benefit system visit


6. Urgent medical attention


If you have an urgent medical question relating to your existing medical condition, or

the condition of the person you are caring for please contact us, or your specialist

hospital care team, directly. Where possible, you will be supported by phone or

online. If your Clinician decides you need to be seen in person, the NHS will contact

you to arrange a visit in your home, or where necessary, treatment in hospital.


To help the NHS provide you with the best care if you need to go to hospital as a

result of catching coronavirus, we ask that you prepare a single hospital bag. This

should include your emergency contact, a list of the medications you take (including

dose and frequency), any information on your planned care appointments and things

you would need for an overnight stay (snacks, pyjamas, toothbrush, medication etc.).

If you have an advanced care plan, please include that.


7. Looking after your mental well-being


We understand that this may be a worrying time and you may find staying at home

and having limited contact frustrating. At times like these, it can be easy to fall into

unhealthy patterns of behaviour, which can make you feel worse. Simple things you

can do to stay mentally and physically active during this time include:


• Look for ideas for exercises to do at home on the NHS website.


• Spend time doing things you enjoy – reading, cooking and other indoor hobbies.


• Try to eat healthy, well-balanced meals, drink enough water, exercise regularly,

and try to avoid smoking, alcohol and recreational drugs.


• Try spending time with the windows open to let in fresh air, arranging space to sit

and see a nice view (if possible) and get some natural sunlight. Get out into the

garden or sit on your doorstep if you can, keeping a distance of at least 2 metres

from others.


You can find additional advice and support from Every Mind Matters and the NHS

mental health and wellbeing advice website.


Further information on coronavirus, including guidance from Public Health England,

can be found on the nhs.uk1 and gov.uk2 websites.



Yours sincerely,


On Behalf The Partners of West Hampstead Medical Centre


List of diseases and conditions considered to be very high risk:


1. Solid organ transplant recipients


2. People with specific cancers


• People with cancer who are undergoing active chemotherapy or 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


• 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


3. People with severe respiratory conditions including all cystic fibrosis, severe

Asthma and severe COPD


4. People with rare diseases and inborn errors of metabolism that significantly

increase the risk of infections (such as SCID, homozygous sickle cell)


5. People on immunosuppression therapies sufficient to significantly increase risk of



6. People who are pregnant with significant heart disease, congenital or acquired






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