New Scottish Covid-19 Clinical Guidelines

Two new Covid-19 Guidelines have been added to the Scottish Palliative Care Guidelines. The new guidelines are for:

• Symptom management for when a person is imminently dying from Covid-19.

• Supporting end of life care when alternatives to medication normally given through syringe pumps are required.

The standard end of life care guidelines should be used for all other situations.

A series of short practical films on relevant techniques and equipment to help professionals giving medicines has also been added to the Guidelines site.

The Covid-19 pages of the Guidelines website now link helpfully to other key palliative and end of life care guidance and resources. We cover these resources in this newsletter, noting that they available via the Guidelines site.

Anticipatory Care Planning

Healthcare Improvement Scotland is working with Scottish Government to produce Covid-19 ACP templates and guidance. Resources are here and include an Essential ACP Planning Guidance and Template. (also available via Guidelines site)

NHS Education Scotland has produced graphics and a film which support ACP. The resources cover 3 topics:

• Stress, Coping and Resilience;
• Difficult Conversations - Why we need to talk about dying;
• Care Homes and Coronavirus.

(also available via Guidelines site)

Communication with Patients and Families

Talking with people and families about planning care, death and dying is a new resource which has been developed to support effective communication in the context of Covid-19. (also available via Guidelines site)

Guidance from the Chief Medical Officer (CMO) on treating patients with COVID-19

This is a key document. It is broad in scope, and sets out key recommendations to guide the delivery of health and social care from community assessment to critical care and end of life care. The guidance includes a Primary Care Triage Guide.

https://www.gov.scot/publications/coronavirus-covid-19-clinical-advice/

Coronavirus (COVID-19) Ethical advice and support frameworks

This guidance is intended to support NHS staff with decision making during the current pandemic.

https://www.gov.scot/publications/coronavirus-covid-19-ethical-advice-and-support-framework/

​​​The COVID-19 Compendium, produced by Health Protection Scotland, contains links to current national and international policy, guidance and resources on COVID-19 from key organisations. It is updated daily and arranged chronologically.

https://www.hps.scot.nhs.uk/web-resources-container/covid-19-compendium/

Education

NHS Education Scotland’s Support Around Death site has gathered a range of resources relevant to the pandemic. Topics include: communication around the time of death; delivering bad news by telephone; death certification and death registration. (also available via Guidelines site).

Learning materials regarding coronavirus (COVID-19) from NHS Education for Scotland are now available here. Other practical and regulatory information for medics is available from the Scotland Deanery.

Also see SPPC News below for another new education resource.

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Hoping for the best, preparing for the Worst

SPPC has produced information and resources designed to support the public through serious illness, dying and loss during the pandemic. This includes support for thinking and planning ahead, and practical advice and support around bereavement and funerals. The page also links to NHS Inform. (also available via Guidelines site).

Advice for People with Specific Health Conditions

Tailored advice for those living with specific medical conditions (including cancer, diabetes, heart disease, IBD; chronic kidney and liver disease; dermatological, neurological, respiratory and rheumatic conditions; and rare diseases) has been published by Scottish Government.

NHS Inform

NHS Inform hosts official Covid-19 health information for the public. New Covid-19 resources include:

An interactive Self-Help Guide to help the public take the right action in respect of certain symptoms and scenarios

A downloadable Communications Toolkit to support public facing organisations, including self-care resources for primary care providers.

Telephone and Online Support

Marie Curie Support Line – 0800 090 2309, email support@mariecurie.org.uk or contact on web chat.

Age Scotland Helpline - 0800 12 44 222

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Evidence

Healthcare Improvement Scotland is identifying reliable sources of evidence for NHS Scotland (and other providers of care) during the COVID-19 pandemic. (also available via Guidelines site)

Rapid Evidence Reviews on Covid-19 related Topics

ScotPalCovid is a palliative care research team at Glasgow University which is doing rapid evidence reviews and sharing their work on a blog. Initial topics have included: hospital visiting; anticipatory care planning; T34 syringe pumps. The group can be followed on twitter @ScotPalCovid

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End of Life Care Toolkit

The Helix Centre have produced an End of Life Care Toolkit. This currently contains a short leaflet for the public on Practical Care for the Dying Person (not Covid-19 or pandemic specific). They have also produced a resource to train and support family/informal carers to administer As-needed Subcutaneous Medicines. This resource is not public-facing and the webpage should only be used by carers who have been identified and assessed as being suitable by healthcare teams. (also available via Guidelines site).

National Institute for Clinical Excellence (England)

NICE continues to produce rapid guidelines relating to Covid-19. You can view the latest here.

Learning pathway – Covid-19 End of Life Care (NHS Health Education England)

Some new documents and videos released as part of existing end of life care online training pathway. No need for log in.

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Education Resource:

Online education for informal carers: an introduction to end of life issues

SPPC has produced an online education module. The module does not look specifically at COVID-19, or dying from COVID-19. Rather, it introduces and explores dying in general – what to expect, and how to help. It comprises a collection of films and reflections designed for ordinary people who want to know more about dying, death and bereavement, including people who have no previous clinical or caring experience. It may also be helpful for health or social care staff without previous experience of palliative or end of life care whose role is changing in response to the COVID-19 situation. Read more here, including how to access the module.

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Taking Care of You

Taking Care of You is a resource which aims to support people working in demanding, high stress, potentially traumatic healthcare environments. It is designed for, and speaks to, the practical realities of busy health and care workers. It offers proven easy tips and techniques you can use before, during and after your shift. (also available via Guidelines site).

NHS England - Face Covid

In this brief animation Dr Russ Harris illustrates how to use ACT (Acceptance and Commitment Therapy) to deal with the Corona crisis and the fear, anxiety and worry that goes with it. (also available via the Guidelines site).

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In case you missed it, another chance to enjoy the “Coatbridge Elvis”.

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A poem by Bertolt Brecht:

When the times darken

When the times darken

will there be singing even then?

There will be singing even then.

Of how the times darken.

Some background on the poem.

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