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Thrombosis and Anticoagulation Services during the COVID-19 outbreak

COVID-19 is a viral infection caused by a newly emerged form of coronavirus particularly affecting the upper airways and lungs. Everyone in the population needs to be vigilant about minimising the risk of infection, monitoring for signs of infection and reducing risk of transmitting the infection to others. We are aware however that our Haematology patients may have particular concerns and needs.

The Haematology team here at St George’s Hospital are here to support you during this difficult and anxiety provoking time.  Whilst it will be necessary to make some changes to the way we deliver care, we will be doing our best to continue your usual Haematology care as far as possible during the coming weeks to months.  We are also here along with the rest of the hospital and community health teams to manage and support you if you have concerns related to COVID-19 and your blood disorder.

To help you keep up-to-date with the latest guidance from St George’s Hospital and nationally/internationally, please find some resources to refer to.

Patients who under the care of our anticoagulation service with concerns regarding exposure to or infection with COVID-19 should refer to the current NHS guidance

https://www.nhs.uk/conditions/coronavirus-covid-19/

If you are self-isolating due to symptoms of COVID-19 or potential exposure to COVID-19 and have an out-patient appointment or blood test,

  • Please do not attend the hospital.
  • Instead contact the Anticoagulation team or Haematology secretaries so we can advise you about rearranging your appointment or reviewing over the telephone.

Advice for patients on warfarin:

If you are on warfarin but would like to consider the option of changing to an alternative anticoagulant which does not require INR monitoring please contact your GP practice who will review your case and oversee the switch.

We understand some of you will meet the criteria for shielding but require ongoing warfarin monitoring, please contact the anticoagulation team who will make arrangements for home testing via the district nurses.

If you have an upcoming INR test the clinic will contact you a few days before your appointment to see if this can be delayed for a few weeks.  You can also discuss whether you have the option of switching to an alternative anticoagulant.

We are currently exploring the option of providing INR testing at other locations in the community for those patients who must stay on warfarin anticoagulation but wish to undergo testing at community sites, in the meantime we continue to provide INR testing at the hospital.

General Advice for Day Unit and Outpatient appointments

We are making efforts to limit hospital visits to minimise the risk of exposure to COVID-19 as much as possible especially for more vulnerable patients.  In some cases we will therefore be contacting patients to make changes to their outpatient appointments.  Where possible, we will be changing face-to-face consultations to telephone consultations.  It may also be necessary to defer some routine follow up or non-urgent appointments.  It is reasonable to query with your individual team whether your hospital visit can be deferred or delivered by telephone.

For most patients on cancer treatment, this will continue but there may be changes in the frequency, dosing or duration of treatment in order to minimise visits to hospital.  This will be communicated to you via your normal clinic appointments

Please do not attend the outpatient department or the day unit if you or anyone you have close contact with is unwell and in isolation with COVID-19 symptoms.

Instead please contact the Haematology Day Unit, your Haematology Clinical Specialist Nurse or the Haematology Secretaries (contact numbers below) to inform us of the situation so can support you and advise you about rearranging your appointment.

Virtual or Telephone Clinics 

During the coronavirus pandemic the NHS is having to adapt very quickly in order to stop the spread of the virus. As part of this effort, and in order to reduce the risk to you and medical staff you may be offered a telephone clinic appointment, where a member of the haematology team will contact you at home.  Please see below the following guidance for these telephone clinic appointments;

  • The phone call will last approximately 10-15 minutes. Please be aware that the phone calls from the hospital appear as a private number so if you are called from a private number around the time of your appointment please answer.
  • Please be available for 30 minutes either side of your appointment
  • We will try and call you 3 times. If you do not answer after 3 attempts we will have to defer your appointment.
  • If you are not sure that we have accurate contact information for you then please contact our secretaries to update this.
  • Please find a place where you are happy to talk about your medical condition.
  • If you need blood tests then the blood test request labels will be sent to you and if you need medications following the appointment then we will arrange it so these can be collected in the community. We will let you know where blood tests can be done.

 

Contact details for the team:

Within working hours:

Anticoagulation Clinical Nurse Specialists: Tel: 0208 725 5443

Anticoagulation Pharmacists: Tel: 020 8725 1763

Haematology Secretaries: Tel: 020 8725 1115

Outside of working hours:

Haematology Registrar Oncall (available via switch board, 0208 672 1255)