Tag Archives: appointments

Covid panic as two UK hospitals declare code black alert – forced to cancel appointments

NHS Grampian said both Aberdeen Royal Infirmary and Dr Gray’s Hospital in Elgin, Moray have now been forced to postpone and cancel non-urgent elective operations due to a sharp rise in Covid patients. Both trusts have also seen a rise in staff members needing to self-isolate due to the virus. NHS Grampian medical director Professor Nick Fluck said: “This is a dynamic situation, subject to change throughout each day.

“I can confirm that both Aberdeen Royal Infirmary and Dr Gray’s Hospital have been at black status in recent days.

“Choosing to cancel procedures or appointments is never a decision we take lightly; however it is our only option if we are to relieve some of the pressure and allow staff to concentrate on the most urgent and emergency care.

“I know it is distressing for people to have procedures or appointments postponed, sometimes at very short notice. I apologise to anyone who has been affected by this.

“We will work to reschedule these, but we cannot offer any guarantees at present about when this might happen.

“If you are accessing any healthcare services, please be aware delays are likely.”

This comes as coronavirus cases, deaths and hospital admissions have begun to rise rapidly in Scotland. 

According to the Scottish Government, 3,799 new cases were reported north of the border. 

Since June 13, case levels have risen sharply and have exceeded 2,000 a day since June 21. 

JUST IN: Brexit LIVE: SNP stuns Boris with sensational bid to change UK rules

First Minister, Nicola Sturgeon has claimed the final easing of restrictions is not set in stone due to the rising case levels. 

Scotland is due to proceed to level 0 on July 19 as England also lifts all restrictions. 

She claimed lifting restrictions must be done in a reasonable and controlled manner due to the increasing case numbers. 

Ms Sturgeon told the BBC: “We are looking at this very carefully.

“My biggest concern right now is that even though we are seeing a weakening of the link between cases and hospitalisations, if we have a high number of cases even a lower proportion of those cases ending up in hospital can put pressure on our NHS.”

This is a breaking news story, more to follow…

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Author: Bill McLoughlin
Read more here >>> Daily Express :: UK Feed

Covid: Patients ‘frustrated’ waiting ‘long time’ for hospital appointments, says doctor

Dr Cannon did say mask-wearing wouldn’t be necessary all of the time, especially in classrooms and shops, but she did say they’d be useful when:

  • Visiting hospitals
  • Visiting GP clinics
  • On public transport.

“I think there will be many people who continue to wear face masks, myself included, even after July 19 if the mandate is lifted,” Dr Cannon said.

Referring to the common cold that typically circulates in autumn and winter, face masks are considered an “easy win”.

“If you can do something simple to prevent [a cold or flu], why wouldn’t you?” she queried.

Author: Chanel Georgina
Read more here >>> Daily Express :: Health
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Lawmakers Debate How Much to Pay for On-Call Phone Appointments

It took covid-19 to give millions of Americans the option of telling their doctor about their aches and pains by phone.

But now that more doctors and patients are returning to in-person appointments, policymakers across the country are divided over how much taxpayer money to keep spending on phone appointments. Although they were a lifeline for Medicaid and Medicare patients who don’t have the technology for video visits, critics say they don’t provide the same level of patient care and aren’t worth the same price.

In California, the Democratic-controlled legislature wants the state’s Medicaid program for low-income people — called Medi-Cal — to keep paying for phone calls at the same rate as for video and in-person visits, a policy that began during the pandemic. But Democratic Gov. Gavin Newsom’s budget plan directs Medi-Cal to reduce the rate.

Medi-Cal paid for a whopping 2.4 million phone appointments from March 1, 2020, to April 30, 2021, according to the state Department of Health Care Services.

“Prior to the pandemic, audio-only visits weren’t a thing,” said Chris Perrone, director of the California Health Care Foundation’s Improving Access team. “No one considered them telehealth.” (California Healthline is an editorially independent publication of the foundation.)

The federal Medicare program — which covers older Americans and people with disabilities — and most state Medicaid programs rarely paid for phone visits before the pandemic. But after doctors shuttered their offices last year and patients stayed home, Medicare and nearly every state Medicaid program began paying for phone visits when it became clear that many patients didn’t have access to video. More private insurers began counting phone calls as telemedicine visits, too.

The use of audio and video appointments — generally known as telehealth — has exploded during the pandemic. In California, there were about 10,500 telehealth visits a week per 100,000 Medi-Cal patients in 2020, compared with about 300 in 2019, according to the state Department of Health Care Services.

Medicare saw a similar explosion. Before the pandemic, about 17,000 enrollees used telemedicine each week. That shot up to 1.1 million weekly during the pandemic, according to a Medicare spokesperson.

While most state Medicaid programs began paying for phone visits during the pandemic, they are weighing how to proceed as it wanes. New Hampshire passed a law in March 2020 requiring Medicaid and private plans to pay for phone visits at the same rate as video and in-person visits. This March, Vermont extended emergency rules to pay for phone visits at the same rate as other types of appointments through 2022, and a state working group recommended keeping them permanently. ConnecticutDelawareNew YorkColorado and other states passed laws that define phone visits as telehealth, and all are continuing to pay for them to varying degrees.

Congress held hearings in April to determine whether Medicare should keep paying for phone visits, which it started doing in March 2020 but is set to stop after the federally declared public health emergency ends. A nonpartisan legislative agency has recommended extending the payments for a year or two after the emergency.

Because audio appointments are new, there’s little evidence on quality. The California Health Benefits Review Program analyzed studies on the effectiveness of telehealth and found that, generally, telephone visits were “at least as effective as in-person” ones. The few studies that directly compare video and audio visits looked at behavioral health care and determined that outcomes were about the same.

Phone visits were important to Taryn Keane, 63, who lost her job as a massage therapist in Venice, California. Keane can’t afford internet service at home and didn’t have a laptop until the Venice Family Clinic gave her an old one and a Wi-Fi hot spot so she could participate in patient forums.

Still, Keane doesn’t like video calls. She has dental problems that make her uncomfortable showing her face on video and a learning disability that makes it hard to focus if there are too many visual distractions. It was easier for her to talk through her mental health issues, and get consultations before and after wrist surgery, over the phone.

“I’m not good on the computer,” Keane said. “It’s just another uncomfortable barrier for me.”

California lawmakers are debating a bill, AB 32, that would require Medi-Cal to keep reimbursing phone, video and in-person visits at the same rate in most settings. The measure, passed by the state Assembly, is now being debated in the Senate and as part of budget negotiations.

An analysis of the bill from the California Health Benefits Review Program found evidence that patients of color and those who are older or rural were more likely to use phone visits than video visits during the pandemic.

“It’s obvious that video [appointments] will not be going to all rural residents and seniors anytime soon,” said state Assembly member Cecilia Aguiar-Curry (D-Winters), author of the measure. “My No. 1 goal is to have access for all.”

Doctors at safety-net clinics that serve Medi-Cal enrollees and uninsured people report that phone visits have been instrumental in keeping patients healthy during the pandemic. They have proved effective with patients with behavioral health issues like substance use disorders, and those with chronic diseases like diabetes, which require monthly check-ins.

Dr. Grace Floutsis, CEO of White Memorial Community Health Center in Los Angeles, used video and phone appointments for the first time during the pandemic. Like all federally qualified health centers, White Memorial generally wasn’t allowed to use telehealth until then.

“What surprised us the most was how many more people had access to care because that was provided,” Floutsis said. “I’m not sure that changes that much after the pandemic.”

Patients have stopped skipping appointments, she said. The no-show rate for pediatrics (now in person) is higher than for adult primary care (still virtual). The no-show rate for behavioral health, once high, has dwindled to nearly zero.

California’s Department of Health Care Services argues that phone appointments aren’t as good as in-person or even video visits and wants to pay for some phone visits at 65% of in-person or video rates, beginning July 1 or when the federal public health emergency ends.

“There are inherent limitations on the types of services and quality provided,” department spokesperson Tony Cava wrote in an email. “They are not typically viewed as equivalent to in-person visits, do not require the same level of resources to manage, and special equipment or broadband internet connections aren’t required.”

Despite multiple requests, the department did not provide data on how much it paid for phone appointments during the pandemic.

Under the department’s proposal, it would no longer pay for phone appointments at community health centers because the health centers receive a flat rate for every visit by a Medicaid patient. The department left the door open to work with health centers and the federal government to pay some amount for audio visits in the future.

The average community clinic appointment in California is reimbursed at $ 215, but some can be several hundred dollars.

“While I think it’s a really valuable service, I don’t think it’s a really valuable service at that cost,” said Assembly member Jim Wood (D-Santa Rosa), who chairs the Assembly Health Committee.

His committee discussed cost in April when it considered AB 32, the bill to keep rates for phone visits equal to the rates for other visits, and amended it to stop reimbursing audio visits at community clinics altogether after five years.

West County Health Centers in Sonoma County is already losing money on phone appointments for Medicare patients, and will take an even bigger hit if Medi-Cal cuts rates, said CEO Jason Cunningham.

But ending phone appointments completely isn’t an option, he said. Phone calls allow patients to conference in family members, eliminate travel time for patients in remote parts of the county, and enabled clinics to keep operating when their buildings were closed for wildfires last summer, he said.

“How can I ask someone to drive an hour to see me, wait in the waiting room for 20 minutes and drive an hour back home when their neighbor with a laptop can see me virtually?” he asked.

This post originally appeared on Medscape Medical News Headlines

Vaccine appointments: How to change or cancel a Covid vaccine appointment

GP practices, pharmacies and vaccine centres across the UK are offering appointments every day for people to get their Covid jabs. Inevitably, some people may find they are unable to attend their vaccine appointments on the day booked. So it’s important people change or cancel their appointments, in order to free up the slot for another person.

How to change or cancel a Covid vaccine appointment

Once someone is eligible, they are invited to book their Covid vaccine appointment via the NHS website.

The online service requires people to book their first and second vaccine appointments at the same time.

Once these appointments are booked, people can also use the online system to cancel appointments and rebook their appointment again.

In recent weeks, the Government announced people may be offered their second vaccine dose earlier than planned.

READ MORE: Charlotte Smith health: Countryfile host on her ‘rare’ disease

Therefore people considered to be in a high-risk group may be contacted and offered earlier appointments for their second vaccine dose.

If people are contacted and offered to rebook, they will need to cancel their existing appointment before a new earlier appointment can be booked.

The NHS vaccine book site can be accessed HERE.

If someone booked their Covid vaccine at their GP surgery, they may have to contact their surgery directly to reschedule their appointment.

Which Covid vaccine will people be offered?

Three Covid vaccines – Pfizer/BioNTech, Oxford/AstraZeneca and Moderna – have been approved for use in the UK.

People using the online booking service will only be offered appointments for the vaccines recommended based on their age, underlying health conditions or whether they are pregnant, according to the guidance.

People under 40 without other health conditions are currently advised that it is preferable not to receive the Oxford/AstraZeneca vaccine.

This is due to concerns over a small number of reports of rare blood clots in recipients of the Oxford/AstraZeneca vaccine.

People who had the Oxford/AstraZeneca vaccine for their first dose should have it again for their second dose if they did not have any serious side effects.

It is also preferable for people who are pregnant to have either the Pfizer/BioNTech or Moderna vaccine, as these vaccines have been used widely during pregnancy in other countries.

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In a statement, Health Secretary Matt Hancock praised the UK vaccine programme and urged people to “take up the offer” of a vaccine when they are eligible.

Mr Hancock said: “Our trailblazing vaccination programme – the biggest and most successful in NHS history – is another great British success story and a testament to what can be achieved when all four corners of the country come together to defeat this virus.

“Our country has one of the highest uptake rates in the world and I’m delighted that so many have answered our call to arms.

“If you have not yet come forward, and you are eligible, I urge you to take up the offer – it could save your life and protect your loved ones.”

This post originally appeared on Daily Express :: Health Feed
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At least 60,000 cases of diabetes went undiagnosed as GPs halted face-to-face appointments

This post originally appeared on Daily Express :: Health Feed

Researchers estimated around 60,000 diagnoses of type 2 diabetes were missed or delayed between March and December 2020. They warned the true figure could be even higher, as lockdown weight-gain and lifestyle changes may have put more people at risk. Diabetes occurs when the body is unable to control blood sugar ­levels. Usually, around 255,000 people are diagnosed annually. Around 90 percent of sufferers have type 2, which is often linked to obesity or lifestyle factors.

Researchers used data from more than 14 million people to compare trends during the pandemic with the past 10 years.

Study leader Dr Matthew Carr, of the University of Manchester, said: “We estimate that, across the UK, the number of people with a missed or delayed diagnosis of type 2 diabetes was 60,000 during 2020.

“We found significant ­reductions in patients with pre-existing diabetes getting the necessary care and medication to manage their condition.”

During April 2020, at the height of the first wave, the rate of new Type 2 diagnoses in England dropped by 70 per ­compared with expected rates.

Although figures improved in later months, they remained below average levels for most of the year.

Older people, men, and those from deprived areas were worst affected. Between March and December, prescriptions for ­metformin and insulin – drugs used to treat the condition – were down 20 percent and five percent, respectively, at GPs in England.

Experts said the shift to more digital appointments to reduce risk of spreading coronavirus had played a role.

Dr Carr said: “Many aspects of diabetes care require direct contact and, as GPs were advised to minimise face-to-face consultations, the fall in diagnosing, monitoring, and prescribing are not surprising.

“However, the magnitude of the reductions is concerning.”

Dr Carr said the NHS should be ­prepared for a backlog of patients – some of whom will have seen their condition deteriorate.

He said: “Effective communications should ensure that patients remain engaged with diabetes services. There also needs to be a greater emphasis on educating patients and providing equipment for home monitoring and remote consultations.” 

The findings were presented at the virtual Diabetes UK Professional Conference.

Nikki Joule, policy manager at charity Diabetes UK, said: “It’s incredibly concerning that rates of type 2 diabetes diagnoses were much lower than previous years.

“Early diagnosis is vital in reducing the risk of serious complications with the heart, kidneys and eyes.”

Tam Fry, chairman of the National Obesity Forum, said the pandemic had disrupted care and monitoring for people ­struggling with their weight. He added: “The primary schools National Child Measurement Programme, which annually spotted increase in obesity figures, was shut down in June.

“Anecdotally, adults have also failed to attend surgeries for their weight because of lockdowns. 

“With obesity being a major risk factor in triggering diabetes and other serious diseases, it is vital that measures to tackle obesity are stepped up. It is generally accepted that there will be further viral epidemics in the future..”

Another study presented at the conference suggested people with undiagnosed type 2 diabetes were waiting on average more than two years to learn they have it.

Researchers at the University of Exeter analysed biobank data from 200,000 people without a diagnosis and found one per cent had average blood sugar levels above the threshold for the condition. Looking at GP records, they found participants typically waited 2.3 years following the blood test to receive a diagnosis. Almost a ­­quarter had not been diagnosed five years later.

Women and people with a lower BMI were more likely to have their diagnosis delayed. An NHS spokesperson said: “We have continued to run our diabetes prevention programme over the pandemic.

“And we have put in extra measures for people with diabetes, including digital consultations and online support for people to ­manage their conditions.”

Meanwhile, another study could help doctors identify people with type 2 ­diabetes who are at higher risk of developing dementia. It found they had higher blood pressure and cholesterol levels up to 20 years before dementia ­diagnosis.

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What happens when COVID-19 vaccine appointments remain unfilled?

AUSTIN (KXAN) — Next week, the wait will be over for thousands of Central Texans in need of a COVID-19 vaccine. This comes as the state will see more than a million dose increase in supply.

The Department of State Health Services says there will be more doses from Johnson & Johnson and local pharmacies will see a big boost.

This is a welcomed relief for some of our viewers who tried to sign up for their first doses of the vaccine through Austin Public Health. On Thursday, many of them saw a tweet saying there were still thousands of appointments left.

Scheduling was closed and there were still appointments available. Austin Public Health told KXAN News almost all remaining appointments were for April 6. Those appointments will be included in its upcoming Monday release for next week’s appointments.

The department says all appointments for the week have still been filling up. However, staffers are seeing the appointments for that following Tuesday (which are available on Thursdays) are not quite filling up as fast and they aren’t quite sure why. Based on these last several appointments, APH is evaluating the release process to possibly expand eligibility within its system.

Currently, there are approximately 250,000 eligible accounts on APH who have not scheduled their first dose. APH believes there is a large number of people who have received a vaccination from a different provider. They launched a feature earlier in the week that allows individuals to update their profile with vaccination information if they received it from somewhere else.

APH says it has been working out a way to allow for the prioritization of groups within its system to ensure people are still able to access appointments when eligibility is expanded to all individuals.

Jennifer Sanders