The information on this page is designed to provide patients with:

• Updates on any changes to services or appointments during the coronavirus (COVID-19) outbreak

• General advice on how to best manage different  conditions

• Where to go to seek more information

All advice for children can be found under paediatrics.

 

A B C D E F G H I J K L M N O P Q R S T U V W X Y X

A


Asthma

Severe Asthma Service (also see respiratory

In line with national NHS guidelines, many of our appointments have been moved to telephone appointments. You will receive notification about this.

Access to the hospital is likely to change on a day-day basis as increasing restrictions are put in place to minimise person-person spread of the virus. We recommend you check the home page of the Trust website for the latest update.

The biologics delivery service will continue, but if you routinely attend for this, you may notice a change to the organisation of outpatients. Visits will be kept as brief as possible.

You should continue to take your medication, including prescribed dose of oral steroids, unless otherwise instructed. Abrupt reduction of oral steroids such as prednisolone without medical supervision can be dangerous, and severely worsen asthma control.

You should maintain ready access to, and follow your personalised asthma action plan, as you normally would.

Telephone appointments/consultations

In readiness for a telephone appointment, please have your peak flow meter and medication including inhalers to hand.

If you are unable to be available for the appointment please call the team on 01223 349 410

Useful links:

Current government advice on self-isolation

Current Asthma UK coronavirus site

Inhaler advice video


Audiology

Due to the increasing pressures on the NHS caused by COVID-19, the local NHS needs to ensure that the maximum possible inpatient and critical care capacity is available in our hospitals to respond to this pressing demand.

This means that the local NHS has made the decision to postpone all non-essential outpatient appointments and planned procedures and operations until further notice, starting on 20 March 2020. We are planning for this to be for a period of at least three months.

This will include our walk-in repair services, however, please be aware that we will still operate a postal repair service. If you require this service, please send your hearing aid(s) in appropriate packaging, with your brown record book and a stamped self-addressed envelope (with a large letter stamp) for return to you.

Our address is:

Audiology Clinic 10
Box 94
Addenbrooke’s Hospital
Hills Road
Cambridge
CB2 0QQ

Information on hearing aid maintenance can also be found by searching C2Hear Online on Google or YouTube, or in the patient information leaflets on our website.


B


C


Cancer

Important: Change in location for receiving chemotherapy

The Oncology Day Unit has now been converted to a larger assessment area for cancer patients. Therefore all patients receiving chemotherapy are currently being treated on the Haematology Day Unit. All patients are being phoned in advance to advise of this. 

The Haematology Day Unit is in a separate block opposite the main entrance to the hospital. You do not need to enter the main hospital. From the main hospital entrance as you face it turn right and follow the walk-way all the way down to the Haematology Day Unit entrance. 

Patients attending for blood tests should currently continue to attend the Oncology Phlebotomy room near Oncology Outpatients. The exception is patients with central lines i.e. a PICC line, Portacath or Hickman line. In this case you should now please attend the Haematology Day Unit instead - this can be as a drop-in; no need to book an appointment.

Cancer Support Team

Due to the current Coronavirus (COVID-19) outbreak the Cancer Support Team has temporarily altered how it supports patients during their experience of cancer.

The team can be contacted Monday to Friday, 09:00-16:00, on 01223 274801. We are expecting a higher than average number of calls, so please leave a message if you cannot get through and we will endeavour to call you back as soon as possible.

You can also contact the team by email on add-tr.Information-Support@nhs.net. This account is checked daily and we will make every effort to respond as quickly as possible to any queries.

For any clinical enquiries, please contact your clinical team as normal.

For financial or benefits advice, please contact the Macmillan benefits advisors on 0345 600 6257.

For further support you can access the main Macmillan website on www.macmillan.org.uk or contact them on 0808 808 0000. 

Government advice for extremely vulnerable people

The UK Government has issued guidance on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19.    

This includes people:

  • with cancer who are undergoing active chemotherapy;
  • with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer;
  • with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment;
  • having immunotherapy or other continuing antibody treatments for cancer;
  • having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors;
  • who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.

Helpful documents

One Cancer Voice Guidance on COVID-19 for Cancer Patients 

Helpful links

Macmillan Cancer Support has specific information on the coronavirus for cancer patients.  

It includes:

  • If you need to do anything differently as someone who is being treated / in remission from cancer / living with a chronic cancer
  • Home isolation
  • Caring for people with cancer

Teenage Cancer Trust

Cancer Research UK also has specific information for cancer patients. 

It includes:

  • How can cancer and treatment weaken immunity?
  • What’s the advice for people with cancer (who have no symptoms of coronavirus)?
  • What do I do if I have symptoms?

Cancer Care Map

FAQs – please click here to read Frequently Asked Questions about cancer services at Addenbrooke’


Children – see paediatrics


Crohn’s and Colitis

We are working with Crohn’s and Colitis UK and British Society of Gastroenterology to keep the most up-to-date information in the public domain.

For the latest advice please visit the Crohn’s and Colitis UK website.


F


Fractures

To help ease pressure on the NHS, many of our facture/elective clinics are being moved to telephone clinics. If your appointment has changed then you will be contacted by us, otherwise you should still attend.

In the meantime, you can find helpful advice on how to best manage your condition on the following website: www.fractureinfo.co.uk


H


Haematology - see Cancer


I


IBD – see Crohn’s and Colitis


K


Kidney (See renal)


L


Liver

Please visit the British Liver Trust website for our latest advice on Coronavirus (COVID-19), which includes all our frequently asked questions about the disease for people affected by a liver condition (including those who have had a liver transplant).

For additional information please visit https://easternliver.net 


O


Obesity

Our Obesity Team is currently experiencing an unprecedented volume of calls. If you need to contact the team for information, please consider emailing  rebecca.richards@addenbrookes.nhs.uk

In light of coronavirus (COVID-19) we have made the following adjustments to our upcoming clinics in order to limit footfall through the hospital and to offer you some protection by keeping them at home as much as possible.

Being seriously overweight (a body mass index (BMI) of 40 or above) increases your risk of severe illness from coronavirus (COVID-19) and so you must be particularly stringent in following the social distancing measures. These are steps you can take to reduce social interaction between people. This will help reduce the transmission of coronavirus (COVID-19).

• Avoid contact with someone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough

• Avoid non-essential use of public transport when possible

• Work from home, where possible. Your employer should support you to do this. Please refer to employer guidance for more information

• Avoid large and small gatherings in public spaces, noting that pubs, restaurants, leisure centres and similar venues are currently shut as infections spread easily in closed spaces where people gather together

• Avoid gatherings with friends and family. 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

Everyone should be trying to follow these measures as much as is practicable.

All routine obesity appointments clinics from Monday 16th March will be replaced with a telephone consultation.

Please keep your clinic appointment time free, and you will be called within a three hour window of your original appointment time. 

We will be postponing assessments and new starts for our Intensive Weight Management Programme.   Bariatric education sessions are on hold for the time being. Surgical, medical and Intensive Weight Management Reviews will be modified but maintained as part of a telephone consultation.

Screening for coronavirus will NOT be undertaken by the Obesity Clinic. It is undertaken via the NHS 111 service.

We thank you for your patience during this time; we will update you all when new information is available.

Please take time to read the guidance on the NHS 111 website in relation to the COVID-19 infection.


Oncology - see Cancer


P


Paediatrics

Cystic Fibrosis and Respiratory Team

Our Cystic Fibrosis and Respiratory Team is currently experiencing an unprecedented volume of calls. If you need to contact the team for information, please consider emailing: jo.bridge@addenbrookes.nhs.uk

You will now be aware that your child or young person should be shielded according to the latest government guidance (https://www.gov.uk/government/publications/guidance-on-shielding-and-pro...)

In light of coronavirus (COVID-19) we have made the following adjustments to our upcoming clinics in order to limit footfall through the hospital and to offer your young person some protection by keeping them at home as much as possible.

Cystic Fibrosis and Lung Defence

All routine CF and Lung Defence clinics and Annual Reviews from Monday 16th March will be replaced with a telephone consultation.

Please keep your clinic appointment time free, and you will be called within a three hour window of your original appointment time. This excludes patients with Thursday Annual Review appointments who will be called Thursday afternoons between 14:00 and 17:00. Telephone clinics will also have SOS slots for urgent enquiries. These slots will be allocated according to clinical need. You may also be asked to provide a cough swab or sputum sample from your young person and these will be posted out to you for return by post.

During the telephone consultation you will have the opportunity to speak to any or all of the CF team as is deemed necessary.

We will be postponing Annual Review tests for the time being. Annual Review consultations will be modified but maintained as part of a telephone consultation.

If your child or young person with CF or lung problem becomes unwell with a cough and/or fever, we would advise that in addition to initiating NHS isolation measures:

• Standard care is maintained

• Oral antibiotics are commenced 

• A cough swab or sputum should be sent in for (CF) culture as you would normally do

• The Respiratory and CF team should be made aware that your young person is ill via the usual channels

• It is crucial that chest physiotherapy is maintained 

Screening for coronavirus will NOT be undertaken by the CF Clinic. It is undertaken via the NHS 111 service.

A hospital review by the Respiratory Team is warranted if the child remains symptomatic after 1 week of oral antibiotics and/or are deteriorating i.e. worsening cough, +/- shortness of breath, +/- chest tightness, +/- chest pain, +/- increased sputum production. 

If you bring your young person to Addenbrooke’s, they may be asked to wear a mask. If they do require admission, they will likely require isolation for the first 48 hours as a minimum. One parent will be allowed to stay with their child in the isolation ward.

If your young person needs a portacath flushed that cannot be undertaken by the Community Nursing Team, we will make appropriate arrangements for you.

We thank you for your patience during this time; we will update you all when new information is available.

Helpful links

Please take time to read the latest UKCFMA statement on the CF Trust website www.cysticfibrosis.org.uk .

Please take time to read the guidance on the NHS 111 website in relation to the COVID-19 infection.

Respiratory Team 

Advice and information for children seen in the paediatric respiratory clinics: 

• Travel within the UK is unrestricted. If you require foreign travel advice, we advise you consult www.gov.uk/foreign-travel-advice.

• Hand hygiene should be maintained with good handwashing techniques, soap and water. Alcohol gel is acceptable.

• Flu like symptoms should be treated as per your asthma action plan or respiratory care plan (if you have one). 

• If you think your child may have symptoms due to coronavirus (COVID-19) then please follow the advice on the NHS website and complete the NHS 111 form

• Surgical masks do not provide heightened protection for you or your child. However, if your child is symptomatic they may be asked to wear one to protect others from getting an infection


Paediatric neuroimmunology service 

The service has been writing to parents and carers of children on immunosuppressant disease modifying therapies to offer advice and guidance.

Patients with the following conditions should all receive letters:

• Multiple sclerosis and are on three weekly subcutaneous Beta interferon (Rebif) injections

• Multiple sclerosis and have received Alemtuzumab

• Multiple sclerosis and are on Ocrelizumab.

• Autoimmune encephalitis and have had Rituximab treatment

• MOG positive transverse myelitis / optic neuritis (Neuromyelitis optica spectrum disorder NMSOD) and are on disease modifying treatment

• Autoimmune encephalitis and are on disease modifying treatment

Our understanding of coronavirus is developing rapidly but there is concern that a variety of immunosuppressive therapies used in the treatment of a range of neurological disorders might increase the severity of coronavirus infections.

The ABN MS and Neuroimmunology Advisory Group has prepared advice on the use of MS treatments based on current knowledge. This guidance will be kept under review as our understanding of the virus develops. Further guidance on the use of other immunosuppressive therapies for a range of immunological conditions will be issued shortly. 

To view the guidance please click here.

Guidance considered:

Advice from the Italian MS Society

European Society for Blood and Bone Marrow Transplantation

The Encephalitis Society


Paediatric Rheumatology 

If your child develops symptoms and you are concerned this may be coronavirus:

  • Follow Public Health England advice (PHE) as per NHS website
  • Don’t stop medication unless this is advised by your health professional team
  • Follow ‘stay at home’ government advice for households with possible infection:

https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance

If your child is on regular medications of methotrexate, mycophenolate mofetil, azathioprine, leflunomide or biologics (eg etanercept, adalimumab, tocilizumab, infliximab, anakinra, abatacept):

  • If in contact with suspected infection – continue medications as usual
  • If mild viral cold symptoms develop - continue medications as usual
  • If unwell with a fever, stop medication, follow PHE advice and self isolate and notify your team who will advise when to restart treatment
  • If persistent cough and unwell, stop medication, follow PHE advice and self isolate and notify your team who will advise when to restart treatment
  • If persistent cough but well, follow PHE advice and self isolate, continue medication 
  • If on steroid treatment: do not stop steroids abruptly; continue them unless advised differently by your health professional team. 

Being on any of the above medications does mean that your child is immunosuppressed and is in the ‘vulnerable’ category when reading government advice. Generally the children and young people in our service are only at ‘moderate risk’ (eg on two medications such as methotrexate and adalimumab). Being on steroid medication (‘prednisolone’) puts your child into the ‘high risk’ group. If your child also has other health conditions such as lung or heart problems this also puts them into the ‘high risk’ group. 

Social distancing advice

You will receive specific notification if your child is in the ‘’high risk’ group, and the measures you will need to take if that is the case. PHE advise on shielding and protecting the ‘high risk’ or ‘extremely vulnerable’  group: 

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

For the rest of us, including children and young people in the ‘moderately vulnerable’ group, the government has announced that none of us should leave our homes unless absolutely necessary. On a positive note, COVID-19 disease in children is reported to be mild, even in those who are immunosuppressed.  Please see latest government advice:

https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people

Use of Non-steroidal anti-inflammatory drugs (NSAIDs) e.g. Ibuprofen

There are media reports regarding the use of NSAIDs in relation to COVID-19. At this time there is not enough evidence to provide clear recommendations. We advise:

  • Taking NSAIDs does not increase the risk of catching the virus
  • If you think your child needs the medication for pain or swelling you should continue
  • If you think your child does not need NSAIDs regularly (due to improvement on other treatment) it would be sensible to use them only as required or try to wean off/stop altogether
  • For treatment of possible COVID-19 symptoms (fever and cough), paracetamol should be used first, if it is suitable for your child to take this medication.

Further advice

If you need further advice about your medication or you become unwell and the doctor looking after you needs advice, please contact the paediatric rheumatology advice line at the hospital where you have your specialist appointments, during working hours (8:30-16:00, Monday to Friday).

Addenbrooke’s Hospital: 01223 254988

Norfolk and Norwich Hospital: 01603 287911

Additional resource:

A helpful slide overview put together by UK and European paediatric rheumatology colleagues can be found here:

https://wordday.org/wp-content/uploads/2020/03/WORDday2020-CORONA-PReS-guidelines.mp4

and the British Society for Rheumatology (advice for professionals):

https://www.rheumatology.org.uk/News-Policy/Details/Covid19-Coronavirus-update-members

Specific advice relating to hospital attendance

Outpatient appointments

Regarding your child’s out-patient appointment at Addenbrooke’s, Jenny Lind, and our paediatric rheumatology outreach clinics:

We are reviewing our clinic appointments to decide whether it is important for us to see your child in person or whether we can review them during a telephone consultation. We are aiming to convert appointments to telephone appointments unless it is essential to examine your child. You will be contacted by the outpatient team to convert your appointment to a telephone review.  If you have not had a phone call prior to your appointment, please contact the clinic to confirm the arrangements. 

If you think your child may have COVID-19 or is unwell, please do not bring them to their routine hospital appointment, but contact your team to let them know you cannot come.

Routine blood monitoring 

In order to further reduce hospital attendance we will increase the interval between blood tests for certain patients on disease modifying anti rheumatic medications (DMARDs) and biologics to 3 months. This extension will only apply to those who have been on these medications for at least 6 months and have not had an abnormal result in the last 3 months.

Booked infusions of medications

These will be going ahead, but not in the usual place. We are making arrangements to keep you as separate from other patients as possible. Please confirm the venue and procedure for your infusion before you attend. 

If you have to self-isolate due to suspected COVID 19 infection in your home, you should not attend for your infusion. Please contact us to defer the infusion date to after the isolation period. 

PLEASE NOTE ADVICE IS CHANGING ON A FREQUENT BASIS AND WE WILL CONTINUE TO PROVIDE THE MOST UP TO DATE RECOMMENDATIONS FOR OUR PATIENTS AS BEST WE CAN.

Pregnant and postnatal women 

All the latest information for pregnant and postnatal women including appointments, attending the hospital and infant feeding is here.

Please familiarise yourself with our latest visitor policy which is here


R


Renal 

For clear and sensible advice for patients with renal disease (including transplant and dialysis) please visit the Kidney Care UK website: https://www.kidneycareuk.org/news-and-campaigns/coronavirus-advice/


Respiratory 

Individuals with chronic lung conditions such as COPD, bronchiectasis and asthma are more at risk of the effects of coronavirus (COVID-19).

To help reduce risk: 

• All non-urgent lung function testing has been cancelled

• All non-urgent face to face clinic appointments will take place via telephone 

Please keep your clinic appointment time free, and you will be called by one of the clinical team within a three hour window of your original appointment time.  

You should follow current government advice on self-isolation. If you become unwell with a cough and/or fever, we advise that you follow your standard plan for exacerbation (infection) management including:

• Continuing your standard medicines 

• If applicable, follow the advice from your previously discussed management plan. This may include commencing antibiotics, nebulisers or steroids. If you fail to improve, please seek medical attention.

• If you usually have a standby course of medications, ensure you have these available.

The respiratory team cannot arrange testing for COVID-19, which is undertaken as per national directives.

For some patients e.g. those with severe asthma receiving biological therapy, the specialist team will inform you on the transition to “home care.”

We thank you for your patience during this time; we will update you all when new information is available.


Rheumatology 

We have prepared a patient information leaflet for patients who are currently taking immunosuppressive medications for rheumatology. Please click here


S

Severe Asthma Service - See Asthma

Show on hub page: 
yes