Introductions and Links
We are curating up-to-date information on COVID-19 for medical staff, students and other healthcare workers in NHS Lothian.
As of 23 March 20, Scotland and the UK are in a lockdown response to the COVID-19 pandemic. Where possible, you should stay in your house except:
- to shop for basic necessities and that should be limited to once a day
- to take exercise once a day - but alone or with your own household, not in groups
- for medical reasons or to care for a vulnerable person
- to travel to essential (e.g. NHS) work if that cannot be done at home (please see at-risk guidance for NHS workers below)
Please also see the daily NHS Lothian Speed Read updates and NHS Lothian intranet resources.
(Last updated 27 May 2020; 18:00)
On this page
- Important Updates
- Logged In Resources
- COVID-19 Webinars
- Doctors in Training
- Medical Students
- Wellbeing and Support
- PPE and Infection Control
- Resources and Guidelines
- Contact Us
Some of these resources will require you to log in to this site (at the top right on browser and phone).
If you don't yet have an account, please email firstname.lastname@example.org using your NHS email.
Reskilling for COVID-19
As more patients became hospitalised with COVID-19, we provided regular interactive teaching sessions for NHS Lothian doctors in training as refreshers in respiratory medicine and other skills for managing COVID-19 patients.
These sessions were run daily using videoconferencing, designed by Dr James Tiernan (resp consultant) and Dr Emma Scahill (clinical teaching fellow).
- be able to perform an A-E assessment
- discuss causes, recognition and management of respiratory failure
- review oxygen therapy and titration
- appreciate the role of anticipatory care planning and escalation pathways
Opens in Google Forms (not friendly to NHS Lothian computers but home / phone works perfectly)
COVID Zone Induction Pack
University of Edinburgh Teaching Materials
This material is available via a special log-in set up by UoE. Using your NHS account, this can be accessed here.
Turas Learn Resources
Access Turas COVID-19 resources with your NHS account.
Senior Doctor Resources
These materials are tailored toward senior clinicians toward helping with decision making in respiratory failure and COVID-19 patients.
The session below was recorded with James Tiernan and a group of interim FY1s on 17-04-20 (all infomation correct as of this time).
00:00 -- Intro
04:32 -- A-E assessment and initial management
11:00 -- ABG interpretation and Respiratory Failure
27:00 -- Cases
38:50 -- COVID management
41:00 -- Role of junior doctors
47:00 -- PPE
49:20 -- Deteriorating Patients and Escalation
1.00:30 -- FAQs
This session was recorded with James Tiernan and some of the interim FY1s (all information correct as of 17-04-20).
Preparation for Critical Care
Following the success of the "Reskilling for COVID-19" webinars, similar online drop-in sessions were planned for any health care worker who had been re-allocated to a critical care environment (or for those looking to prepare themselves for future changes).
These sessions were run by ICM and anaesthetic registrars covering: critical care environments and equipment, systems and processes, troubleshooting, common emergencies, and management of specific ITU conditions.
VIDEO - webinar recorded 23 April 2020
00:00 - introduction
03:52 - what is "critical care"?
06:49 - equipment
32:25 - daily assessment
41:15 - CXR interpretation
47:25 - critical care emergencies
57:22 - tracheostomy management
64:09 - specific critical care conditions
71:30 - summary
Course - COVID-19 Critical Care: Understanding and Application
The University of Edinburgh and Royal College of Physicians (Edinburgh) have created a free online course developing themes discussed in this webinar including: daily critical care practice, ventilation and organ support, COVID-19 specific care, self-care and staff wellbeing.
Critical Care Handbook (developed by UoE MSc Critical Care faculty)
NHS Lothian ICU Infusion Guide (last accessed 13-04-20; these are the "yellow sheets" in ITU)
Intubating COVID-19 patients
Video from RIE Critical Care (filmed 11-03-20)
Proning in ITU
Video from RIE Critical Care (filmed 11-03-20)
In April 2020, we had nearly 150 final year medical students join the number of other nursing and AHP students who graduated early to work in South East Scotland and support the NHS response.
The induction programme delivered at the end of April for our new FYs is here, including links to a number of useful induction videos on a number of useful themes for FY work.
Teaching for FY doctors, with a focus on the interim FYs, is an ongoing process which can be accrued for next year's ARCP process too.
Allocation and Remobilisation
Across the UK, doctors-in-training are at the frontline of the NHS response to COVID-19.
To facilitate this, the usual rotations and training have been suspended, and some doctors are getting allocated to areas needing increased medical support.
This situation is being closely managed by the MED team - details of this process are in this allocation document (from 01.04.20).
If units are returning to normal working, then trainees should also be returned to their normal training positions. This will be coordinated by the MED team, with this guidance from NES (01-05-20). The normal rotations in August are intended to continue as planned.
If you have questions regarding your banding or payroll issues, you can contact Medical Personnel by email.
COVID unit induction guide
This is a pan-Lothian guide to working in the COVID zones in RIE, SJH and WGH. This has relevant contact numbers, information on diagnostic tests and management pathways but is constantly under review and update so please check here for the latest versions. If there is information you feel would be useful to include, please discuss with your local medical team (including the authors on the front page) or you can contact us.
Senior Decision Guidance
This document has been prepared by the Lothian Respiratory team to help support registrars and consultants who are moving to COVID Zones. Included is advice on escalation pathways, common respiratory conditions and PPE guidance.
Anticipatory Care Planning
All adult admissions in NHS Lothian should be accompanied with a recorded Anticipatory Care Plan (a copy of the form is available here). This is a standardised document which staff will be able to refer to throughout the patient's hospital admission. It should be completed by the most senior doctor available, in consultation with the patient, family and with the responsible consultant.
The paper form is required in all admissions, and this should also be actioned on Trak within the EPR (Green C indicates full escalation, red C with line through indicates DNACPR).
Part of this process will involve discussions with patients regarding anticipated levels of care and DNACPR status. With the Palliative Care team (Dr Colette Reid, Dr Stephen Fenning) we have created the videos below as examples of conversations you may have with patients and family members around dying, particularly during this COVID-19 pandemic. They have prepared some phrases which you may find useful when having these discussions (PDF here).
Not On Site Working
There is a small number of doctors who due to existing health conditions or pregnancy have been advised to step back from front-line clinical work (the information regarding at-risk groups is available here).
Looking after yourself is a priority, but we know that a number of you are still wanting to support your colleagues and contribute where you can.
There are a number of ways that non-clinical work (even from home) can help, and be counted as work suitable to match the Gold Guide for trainee progression (including updates regarding Outcome 10 and COVID-19). A guide produced by some of our not-on-site doctors on what to prepare and cover is included here.
- NES - August Training Rotations (19-05-20)
- Junior Doctor Contractual Provisions (rota, banding, leave) during COVID-19 (09-05-20)
- NES Principles for Return of Redeployed Trainees (01-05-20)
- 4 Nation (inc. NES) ARCP Decision Aid (late April 2020)
- ARCP codes relating to COVID-19 (late April 2020)
- UK training bodies summary document (late April 2020)
- COPMeD - SOAR FAQs and guidance (24-04-20)
- NES - Welcome to FiY1 Letter (23-04-20)
- UKFPO - Welcome Letter to Early Graduating Doctors (Scotland) April 2020
- NES - Specialty Recruitment with COVID-19 (30-03-20)
- AoMRC - Exams for doctors in training (19.03.20)
The University of Edinburgh has made changes to the formats of year 4 and 5 to allow NHS staff to deliver clinical care to patients. More details can be read on each year's Learn discussion board and in this letter from Prof Kluth (17-03-20).
The final year (year 6) students who passed their final examinations wereinvited, as with other final year students across the country, to help clinically by starting interim Foundation doctor positions. Please welcome them to NHS Lothian and support them, as they will support us.
Academic Year 2020/21
Plans are still being finalised but the future of clinical teaching in the University of Edinburgh and across NHS Lothian will look very different to what came before COVID-19.
Year 4 will follow a 10 week model of rotations, in the community and primary care, acute hospital services, and specialist / outpatient specialties.
Years 5 and 6 will also have adjustments, to broader clinical placements.
Students in all these years will have longitudinal ward based placements, including making use of hours outside 9-5, with the intentions of reducing student rotation throughout our units and increasing clinical experience. Measures will also be taken to reduce exposure to AGPs.
Doctors in Training Drop-In
Working as a doctor is tough at the best of times, and especially when we are dealing with a scenario like COVID-19. Whether you are having a stressful time on the ward or are stuck in self-isolation at home (or anywhere in-between), you are welcome to drop-in and have a chat about anything that's on your mind.
There are on-site drop in sessions currently arranged at RIE and WGH. These take the time set aside for lunchtime Foundation teaching and give all doctors a chance to come together (with appropriate distancing) to have a sandwich and a chat. Members of the MED team (including your ADME) will be there to speak with too.
RIE: Postgraduate Education Centre, Tuesday 1200-1400
WGH: Medical Education Centre, Thursday 1200-1400
For those who can't make these sessions, or are working elsewhere, we also offer Virtual Drop-Ins on Zoom hosted by one of our Clinical Teaching Fellows, Dr Brendan Cavanagh.
The drop-in sessions run from 13:00-13:45 on Tuesdays and Thursdays.
The link to the Zoom session is below (accessible by logging into this website; if you need access please contact your local Educational Co-ordinator or email us). The code for the zoom session can also be found on Trickle.
Our MED team will also make impromptu visits to clinical teams for those who can't make the drop in sessions.
NHS Lothian Advice Line
(Monday - Friday, 0800-1800)
0131 537 8530 (ext. 88530)
Staff are not to call RIDU or our Public Health teams with queries, as both areas are under extreme pressure.
Open to all NHS Lothian staff, confidential psychological support and guidance
T: 0131 451 7445
Occupation Health Staff Counselling and Support
Self referral process to OHSCS@nhslothian.scot.nhs.uk
"self refer" as message title, and include your name, date of birth and a contact number.
STAFF LISTENING SERVICE - EDINBURGH AND LOTHIANS HEALTH FOUNDATION
T: 07888998084 (between 9am and 9pm, calls last 30 minutes and you can re-call)
Accommodation Support for NHS StaffThis is available for staff for a number of reasons including:
- difficulty getting to / from work due to increased distance or reduced public transport
- if shielding a high risk individual(s) at home
- if a suspected / confirmed COVID-19 individual(s) at home
A number of local hotels and accommodation services have expressed support and interest in offering places for NHS staff between shifts or available for on-call support.
Initially please contact email@example.com who can help arrange placement for you as required; they are updating their policies in the coming days. Out of hours, contact 0141 223 1904 quoting “front line NHS staff emergency accommodation” and provide your name, ward, hospital, and work telephone number.
More information is on the Travel Team page of the NHS Lothian intranet (including the TA01 form which can be completed retrospectively).
Edinburgh Medics' Share
A medical student led volunteer group offering childcare and support for health care professionals.
Food and Supplies
This PDF has links to supermarket times and a number of excellent local businesses who are continuing to provide food deliveries in and around Edinburgh and the Lothians, some with special discounts for frontline NHS staff.
Canteen: Opening hours extended (now continuous 0700-1930, with extended meal times)
Project Wingman Lounge: Arthur's Seat PGEC 0630-2100
Aroma: hot and cold drinks, with sandwiches / snacks available 2100-0000 (supported by FeedNHS)
Dining Room: Open 0700-1930 - hot drinks and snacks available all day.
Cooked: breakfast 0700-1000 // lunch 1145-1400 // dinner 1630-1900
Tea/Coffee Facilities in MEC 24/7
Twice weekly Zoom sessions - links here
City Cabs Edinburgh are raising funds supported by a GoFundMe campaign. Staff are asked to share their campaign on social media, call 0131 228 1211 to arrange your lift, quoting "NHS Heroes", and show your NHS ID to your driver to qualify.
Currently there is a 40% discount for NHS staff.
National / Online Services
Wellbeing and Self-Care (ICS)
The second page in particular has a number of suggestions and tips excellent for general use.
A PDF resource to help with shift work during COVID-19, including simple checklists before getting home.
If need to speak with someone:
BREATHING SPACE: breathingspace.scot - T: 0800838587
SAMARITANS: samaritans.org - T: 116 123 (free phone)
SHOUT: giveusashout.org - Text 85258
FRONTLINE 19: frontline19.com free counselling service
Free app access for all NHS staff throughout 2020 (register with NHS email).
Unmind - use NHS email
From sleep and coping through to parenting and supporting others, we provide tools and training across the entire spectrum of mental health.
Ten Percent Happier
Free podcasts and online guides to caring and coping with the anxieties and challenges presented by COVID-19.
A number of stores and supermarkets have either dedicated times for NHS staff, or priority access.
This changes regularly so please check with your local supermarket / suppliers for times to shop.
(confidential and peer support line for doctors and medical students)
0330 123 1245
As well as the additional food and drink facilities being set up, the MED has secured funding for recliner chairs to be added in a number of locations around our acute hospitals, to provide suitable space for doctors in training to have a safe rest space.
Some beds (for short spells of rest) are also available, and other rest facilities are provided by some specialties already.
4 recliners in Braids Room (PGEC). Beds in Doctors' Mess (close to ward 104).
CSAC and Wellbeing Wing (former Library on South Corridor)
3 recliners in Wellbeing hub / Doctors' Mess in Education Centre
Recliner for trainee doctors in CAHMS. Bed in ADC.
3 recliners in HAN space
All parking on the RIE site is now free-of-charge (until September 2020).
Day time: Staff are asked to park in 2C (or if directed to, 2B). This leaves 2A and 1G closest to the hospital entrances available for patients (also free-of-charge).
Night time: Staff are asked to park in the closer car parks (1G, 2A, 2B) to facilitate quicker leave times and morning arrivals to the main staff care park.
As well as the existing "pass" staff car parks, parks 9 and 7 (around DCN) are now allocated to NHS staff, as is the top storey of the parking beside RVB. Passes are available (via your clinical managers) for Westwoods and Fettes spaces, and the Village Hotel at the Crewe Road roundabout has offered its car park for NHS staff too.
Parking along Carrington Road and other local streets is also available, and City of Edinburgh Council has currently suspended charges.
RHSC / Central Parking
- NHSL - Guide for Proning out with HDU/ITU Level Care - 17-04-20
- Diabetes UK - Management of Diabetes in COVID-19 Patients (09-04-20)
- RHSC - Interim Guidance for Deteriorating Suspected/Positive COVID-19 Paediatric Patient (03-04-20)
- NHSL - Guideline for Adult CPR in COVID-19 patients, v1.2 (25.03.20)
- Anticipatory Care Plan (all adult admissions in NHS Lothian) (24.03.20)
- NHSL - Oxygen Support / NIV Flowchart (consultant level decision) (20-03-20)
Organisational / Workforce Updates
- NHSL - PPE Community and Hospital Guidance 09-04-20
- CMO Letter - Clinical Trials during COVID-19 (02-04-20)
- NHS Lothian Occ Health - Staff Testing for COVID-19 (25.03.20)
- NHSL - Death Certification and COVID-19 (PPT)
- Scot Gov/CMO - Death Certification during COVID-19 - 24.03.20
- NHS Lothian Guidance for staff in at-risk groups (23.03.20)
Ways to get in touch
The LTMF is a grouping of trainees, trainers and managers in NHS Lothian, and is a great opportunity to find out what is going on at work and in training, and to raise questions via your representatives.
Please apply here to be included in the LTMF mailing list and find out about future meetings. These are usually held bimonthly but are looking to increase in frequency.
Trickle is a new feedback service we have launched for doctors-in-training earlier this year.
Downloadable as an app or through your browser you can raise issues and ask questions relating to your work and training. Trickle lets you see what people are talking about and you can upvote topics for discussion.
More details are here on the Trickle page.
National Clinical Advisor, Scottish Government (26-03-20)
Michael is Senior Visiting Fellow at The King’s Fund and Professor at Lancaster University. He has worked with us in NHS Lothian before and shares here his ideas on wellbeing while dealing with COVID-19 (25-03-20)
Produced early April 2020. Supported by NHS Lothian Medical Photography and Edinburgh Children's Hospital Charity. More infomation on RHSC pages.
Supporting doctors in training
NHS Lothian published guidance for allocation of DiTs in acute services and are making plans to remobilise to normal training before normal rotations in August.
You can find information on training as well as materials for ACP discussions, online interactive respiratory skills teaching and support sessions.
The latest information for staff regarding testing and NHS Lothian PPE guidelines are published above (updated 09-04-20).
Looking after yourself
Symptomatic (new continuous cough and/or temperature 37.8° or higher): self-isolate for 7 days. Health care workers can return after this 7 day period when apyrexial for 48 hours (even if ongoing cough).
Household symptomatic: the whole house must isolate for 14 days.
Further advice in the HPS / NHS Lothian occupational health links (including for high/increased risk health conditions and staff testing) above.
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