Homerton elective services


Homerton have outlined their initial response to managing the impact of COVID-19 as follows:

Elective (Planned Procedures) – all non-urgent and non-cancer are cancelled.

Outpatient - all follow ups from 18th March to 31st March to be cancelled with the exception of Cancer and other specified cohorts. Those cancelled along with all April New and FUP attendances will then be clinically reviewed and categorised:

  • Clinically urgent and require face to face – appointment to be booked.
  • Patients requiring an appointment in current timeframe but can be seen non-face to face – non-face to face appointments to be booked.
  • Patients not clinically urgent and not requiring appointment within current timeframes – either discharged back to GP or appointment delayed to a later date.
  • Consideration also to be given to safeguarding, vulnerable adults, advocacy requirements amongst other.

e-RS will no longer have routine directly bookable slots – referrals can still be made (as defer to provider) and will be vetted for urgency as above.

2ww Referrals – these will continue as normal – please only use 2ww slots for cancer referrals as per current practice.

Direct Access diagnostics including pathology will continue as normal.

Endoscopy – routine and surveillance procedures are cancelled (direct access for symptomatic patients will continue).

Advice and Guidance – will continue as normal – please make the most of the services to reduce the need for routine referral.

GPs are asked to consider

  • Limiting the level of non-urgent referrals in to all services and increasing the use of A&G services.
  • Making it clear on any urgent referral/request where a patient is exhibiting any Covid-19 symptoms to enable appropriate plans to be put in place.
  • For Direct Access imaging, where management of the patient would not change based on the imaging finding, requests not to be made. Aim to restrict referrals to where there is an immediate and urgent need for imaging whilst also considering whether referring a patient to attend for a diagnostic would increase risk to patient.

Rheumotology Patients - telephone clinics are in operation and clinicians will be making a clinical decision as to whether a patient does require a face-to-face consult.

“We are not stopping immunosuppression at present, but if the patient develops new symptoms ie cough or fever etc,  then should stop mtx and leflunomide. Sulfasalazine and hydroxychloroquine are safe to remain on.

"We are also stopping all iv biologic infusions and IV/ SC osteoporosis therapies.

"We are pausing all new starters to biologics.

"All patients need to have flu, pneumococcal and whooping cough vaccinations.”

See the links below for more info:

www.rheumatology.org.uk/news-policy/details/Covid19-Coronavirus-update-members

www.eular.org/eular_guidance_for_patients_covid19_outbreak.cfm

It should be noted that the situation may change on a daily basis when further information will be released.