COVID-19

 

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 Mar 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 29 Mar 20; 17:00)

 
 

Important Updates

Message from Jason Leitch for Lothian doctors in training

National Clinical Advisor, Scottish Government (26-03-20)

Message from Michael West for Lothian doctors in training

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)

PPE update (25.03.20)

Sara Robinson (RIE, ADME) on PPE in hospital settings

 
 

Events

 
 

Doctors in Training

 

Reskilling for COVID-19

Reskilling Sessions

As more patients are becoming hospitalised with COVID-19, we are providing regular teaching sessions for NHS Lothian doctors in training as refreshers in respiratory medicine.

These sessions will be run regularly using Zoom videoconferencing, hosted by Dr James Tiernan (resp consultant) and Dr Emma Scahill (CTF). Zoom works on most NHS computers and personal mobile devices.

The link to the Zoom session is below and accessible by logging into this website. If you need access, please contact your local Educational Co-ordinator or email us.

Session Objectives

  • 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 ACPs and escalation pathways

University of Edinburgh Teaching Materials

1. Go to https://media.ed.ac.uk/playlist/dedicated/1_07jdkule/ and ignore the error message about source video, it’s because “GUEST” doesn’t have access
2. Click on “GUEST” then “Login” (in the top right hand corner)
3. Enter the username v1nvisit and the password nhsmedia1
4. The first video in the playlist will show, click play to watch.
5. Select an alternative video from the list on the right hand side as appropriate.

Use of this account is subject to the University Computing Regulations and information is collected in line with the Privacy Statement. Please treat as if confidential material (i.e. do not download, share etc).

Turas Learn Resources

Access Turas COVID-19 resources with your NHS account.

 

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.

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).

ACP Introduction
ACP Discussion with Patient
ACP Discussion with Relative
 

Allocation

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 20.03.20).

COVID unit induction guides

RIE (pdf)

WGH (in development)

SJH (in development)

Specific documents during COVID-19

Anticipatory care plans

CPR guidelines (NHS Lothian)

Oxygen therapy guidelines (senior level decisions)

 

Your medical training during COVID-19

If you have questions about your training (Foundation or specialty programmes), visit the Scotland Deanery website or email: deanerycovid-19enquiries@nes.scot.nhs.uk NES also has the Professional Support Unit who can help you if you have personal wellbeing issues you feel are not being addresed directly by your trainers (psu@nes.scot.nhs.uk).
 
 

Medical Students in NHS Lothian

 

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 have passed their final examinations have been invited, as with other final year students across the country, to help clinically by starting locum Foundation doctor positions. Final details are being organised, but we expect to have these new doctors working with us by Easter. Please welcome them to NHS Lothian and support them, as they will support us.

Clinical Support

If Y4/5 students are interested in supporting the NHS clinically, the Staff Bank has started to advertise ward based positions.

Health Care Support Workers / Administrative positions (ref: 019670)

Nursing / AHP positions (ref: 019662)

NHS Lothian Staff Bank Recruitment Number - 0131 536 2020

Research Support

There are a number of COVID-19 dedicated research projects which require help with data collection and analysis. Senior medical students are invited to help on a voluntary basis. If interested, please contact Prof Tim Walsh's team by emailing Miranda.Odam@nhslothian.scot.nhs.uk

 
 

Wellbeing and Support

 

Doctors in Training Support Group

Working as a doctor is tough at the best of times, and especially when we are dealing with a scenario like COVID-19.

We want to provide you with the chance to come together and talk through your experiences, share your stories and how you are feeling.

Dr Brendan Cavanagh is one of our Clinical Teaching Fellows and a psychiatry registrar. He is going to hold daily Zoom sessions (1300-1345) which you can join, in the comfort of social distancing.

The link to the Zoom session is below and accessible by logging into this website. If you need access, please contact your local Educational Co-ordinator or email us.

 

Wellbeing and Self-Care (ICS)

A PDF resource developed by the Intensive Care Society.

The second page in particular has a number of suggestions and tips excellent for general use.

Edinburgh Medics' Share

A medical student led volunteer group offering childcare and support for health care professionals.

Facebook Group (sign in required)

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.

Food and Supplies

Dedicated NHS supermarket shopping times: see below (please check for local store alterations)

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.

RIE Canteen
Opening hours extended (now continuous 0700-1930, with extended meal times)

BMA 24/7

(confidential and peer support line for doctors and medical students)

0330 123 1245

Ten Percent Happier

Free podcasts and online guides to caring and coping with the anxieties and challenges presented by COVID-19.

Ten Percent coronavirus resources

NHS complimentary access

Headspace

Free app access for all NHS staff throughout 2020 (register with NHS email).

Headspace

Accommodation Support for NHS Staff

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 (including Ten Hill Place, Black Ivy, Ronald McDonald House, and some Airbnb providers.

Initially please contact travel@nhslothian.scot.nhs.uk who can help arrange placement for you as required; they are updating their policies in the coming days.

 
 

PPE and Infection Control

Donning and doffing PPE

10 minute video produced by our colleagues in Imperial https://twitter.com/traumagasdoc/status/1238857530715095040?s=20

COVID-19 Intubation (AGP)

Video from RIE Critical Care (per 11.03.20 Aerosol Generating Procedures guidance)

ITU Proning for COVID-19

Video from RIE Critical Care (filmed 11.03.20; published 23.03.20)

Guide to obtaining nasal / throat swab for COVID-19 in the community

5 minute update

 
 

Resources and Guidelines

 
 
 

FAQs

Answers (as we have them) to questions from our doctors-in-training.

FAQs (26-03-20)

Let us know what you need to know on Trickle or by talking to your trarinee reps, the ADMEs or anyone else in the MED team.

 

Ways to get in touch

Lothian Trainee and Management Forum

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

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.

NES

NHS Education for Scotland has FAQs from trainees across the country with information abotu training, exams and the ARCP process.

There is also the NES email hotline checked daily by NES lead deans/managers.

 
 

Other MED Resources

Simon Edgar (Lothian DME; 22.03.20)
 
Supporting doctors in training

NHS Lothian have published guidance for allocation of DiTs in acute services (20.03.20).

You can find information on training as well as materials for ACP discussions, online interactive respiratory skills teaching and support sessions.

Keeping safe

The latest information for staff regarding testing and PPE guidelines are published above.

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.