RESOURCES

In order to support nurses returning to SACT practice during COVID-19 the Guy’s’ Cancer Academy are providing free access to the video lectures from their online SACT course.  If you would like to gain access, please ask your manager to email Julie.Bishop@gstt.nhs.uk . Your manager needs to provide your name, email address and place of work. They need to confirm that you are someone who has previously been SACT competent and are required to update your knowledge and skills to be able to return to SACT practice.

The latest document to be released is entitled ‘Clinical guide for the management of cancer patients during the coronavirus pandemic’ and is available here https://www.england.nhs.uk

/coronavirus/publication/specialty-guides-cancer/

This lays out the principles of prioritising oncology patients for surgical, SACT and radiation therapy and also provides some general principles of managing oncology patients during the pandemic. This document will be accompanied in the next few days by further advice on specific prioritisation of oncology patients receiving SACT. As soon as we have this, we will circulate it. This advice may well result in some patients being advised against coming into hospital for treatment if the benefits from the treatment are outweighed by the risks

It is likely that there are groups of oncology nurses that may need to deploy into areas to administer chemotherapy/SACT. It takes three months to train a SACT nurse. Instead, consider retraining nurses who have moved to other cancer nursing specialist roles. The process can be supported by the UK Oncology Nursing Society (UKONS) SACT Competency Passport. This includes theoretical and clinical practice assessment components Nurses identified for retraining should:

1. Have administered SACT within the previous 2 years

2. Evidence completion of theoretical training (e.g. the passport or accredited course)

3. Complete the relevant passport clinical competencies with a practice assessor.

Retraining can be supported though local clinical/practical refreshers e.g. cannulation and UKONS tools available from  https://www.ukons.org/ . This includes the passport and free on-line e-learning films https://www.ukons.org/events/free-online-sact-learning-resource/

It is important that we continue to support and educate patients starting treatment to manage their side effects and to report symptoms appropriately to acute oncology services. Pre-treatment consultations can be conducted by telephone or via video link. UKONS have produced a film to support patients and explain the contents of the CRUK ‘Your Cancer Treatment Record to accompany these consultations. This film can be accessed here https://www.youtube.com/watch?v=aWmm1_wO5WI&feature=youtu.be  

Omitting all non-essential hospital visits is a sound principle which has resulted in many hospitals utilising telephone or video-conferenced clinics instead. Specialist cancer nurses are already involved in these clinics and the discussion and outcomes need to be captured and documented accurately.

Many providers of chemotherapy/SACT have reviewed their provision of scalp cooling in light of the pandemic. Some have chosen not to offer scalp-cooling at all or reduce their offer. This is in order to reduce the length of time patients spend on chemotherapy units and also to address capacity issues. UKONS believe that these decisions should be discussed with patients, and where possible that there should be an element of patient choice. These are understandable decisions but there may be other resources and activities which can help with continuing to provide scalp-cooling. Paxman Scalp Coolers are offering to help with initial patient education, and this would lighten the load for scalp cooling, and minimize contact time as much as possible. There is a clear need for social distancing, which is challenging when assisting a patient with the cold cap, in addition to possible staffing limitations. Paxman can assist patients in preparing their own hair, fitting the cap and operating the system by accessing remote teaching. This would cover all areas from the initial cap sizing process, putting the cap on correctly, to support a patient through scalp cooling during chemo infusion. These calls can be facilitated through one to one FaceTime, WhatsApp video call or Zoom meetings with the Paxman team training team. If you would like to take up this service, please make contact with Paxman via patientsupport@paxmanscalpcooling.com  The Paxman Scalp Cooling private Facebook group is also open all hours to provide peer to peer support for patients where they can talk to others who are cold capping and access advice and support

Delivery of systemic anticancer treatments (9.4.20) latest update from NICE. Available at:  https://www.nice.org.uk/guidance/ng161/chapter

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On 3 April 2020, they added 2 recommendations on when to offer and continue systemic anticancer treatment for patients with COVID-19. They also amended the table on prioritising treatments in line with new advice from NHS England. Available at https://www.nice.org.uk/guidance/ng161

Many of these services will now find themselves in the front-line of dealing with unwell oncology patients coming into hospitals. It is important that patients on chemotherapy continue to utilise the UKONS Triage lines and do not take the general advice to self-isolate if they develop symptoms. It is a good principle to try and separate oncology patients from other group and are subjected to specialist assessment when they attend the hospital, but we recognise that this may be logistically difficult in terms of space and specialist staffing. It is also important patients may still develop Neutropaenic Sepsis and need to be treated within 1 hour with intravenous antibiotics. The symptoms of neutropaenic sepsis and COVID-19 may appear similar in the first instance and there is a risk that oncology patients with neutropaenic sepsis may be treated as COVID-19, and vice versa

Acute Oncology Services play a key role in the assessment and management of those cancer patients who have been identified as most vulnerable and are more at risk of becoming seriously ill if they contract the coronavirus (COVID-19) infection. An expert group, including some UKONS members, have provided input into producing this document as a consensus of the development and review groups’ views on best acute oncology practice. The guidance aims to clarify and support the continued provision of acute oncology services in light of the current COVID-19 pandemic and the extreme pressures being experienced within the NHS. This guidance should be used in conjunction with any local policies/procedures/guidelines and should be approved for use according to Trust’s own clinical governance process. Care has been taken in the preparation of the information contained in the guidance. Nevertheless, any person seeking to consult the guidance, apply its recommendations or use its content is expected to use independent, personal medical and/or clinical judgment in the context of the individual clinical circumstances, or to seek out the supervision of a qualified clinician.

The document is available here https://ukons.org/site/assets/files/1134/aos

guidance_with_review_group_final310320-3.pdf

Produced a harm review template which can be used when treatment is changed or curtailed. Some clinicians are using these in order to outline the decisions made when treatment is modified due to the epidemic. This is simple to use and is accessible here https://www.rcr.ac.uk/sites/default/files/docs

/general/pdf/RCR_SI_Guidance_August2013.pdf

Have published advice on radiotherapy and have now supplemented this by giving advice on imaging in the current pandemic. This is available here https://www.rcr.ac.uk/college/coronavirus-covid-19-what-rcr-doing/coronavirus-covid-19-resources/coronavirus-covid-19

A summary of the thinking of the Royal College of Radiologists is to be found here https://www.rcr.ac.uk/college/coronavirus-covid-19-what-rcr-doing/rcr-position-coronavirus-covid-19-clinical-oncology  There is a recognition that ‘clinicians may  need to depart from established treatment pathways and protocols’ and the process for considering this as a multi-disciplinary team. Many of the measures are based on the need to try and reduce attendance in the radiotherapy department. An example of this might be the reduction of attendance for patients undergoing breast radiotherapy using the results of the FASTFORWARD trial. This has already been adopted by some radiotherapy centres. This should be discussed with breast clinical oncologists to gain their opinion of feasibility. Other similar measures may well be adopted, and patients will need to be kept informed of the rationale for these changes

Have published a set of new webpages, incorporating all the information gathered over the last couple of weeks, which will be updated quickly and frequently, as new advice, guidance and resources become available.  You can find them under the ‘About lymphoma’ tab here https://lymphoma-action.org.uk/covid-19-and-lymphoma

(2020) for COVID19 available here: https://www.nice.org.uk/guidance/ng164

This is a good summary of the general principles guiding the delivery of oncological and haemato-oncological services during the pandemic. It is available here https://www.mja.com.au/journal/2020/212/10/

managing-haematology-and-oncology-patients-during-covid-19-pandemic-interim

Page has published a set of new webpages, combined from all the information gathered over the last couple of weeks. These pages are continuously updated as new evidence and guidance becomes available. Patients and their loved ones can access all they need through our link: www.bloodcancer.org.uk/support-for-you/coronavirus-covid-19/coronavirus-blood-cancer/

Macmillan have published some guidance for patients and carers who are approaching the end of life during the current pandemic. This is an excellent resource and is very clear. Available here: https://www.macmillan.org.uk/coronavirus/end-of-life-care-and-coronavirus 

In addition to this CRUSE have also published some very helpful material on bereavement and grief during the crisis which is aimed at those left behind when someone dies during this time. Accessible here: https://www.cruse.org.uk/get-help/coronavirus-dealing-bereavement-and-grief

The APC have collated useful online resources to support your palliative care response to COVID-19. This is not an exhaustive list but is selected for important and reliable sources. The UK resources are placed first, and the NICE guidance (see above) is particularly important. International resources are also useful but may be less directly relevant to the UK situation and any medication references will differ of course. https://docs.google.com/document/d/1HR1ulUBb

CjlITkuB-sUQJZ90yx9l2v3N_JUqPMm7qpw/mobilebasic

The Medicines and Healthcare Products Regulatory Agency (MHRA) are adopting a flexible and pragmatic approach, with regard to regulatory requirements for clinical trials during this time. They have recognised that clinical trial resource may be absent or redeployed from research activities and regulatory affairs towards front-line care. Their first priority is the safety of trial participants. This guidance will be updated as the situation changes over time and contains information on pausing clinical trials.. https://www.gov.uk/guidance/managing-clinical-trials-during-coronavirus-covid-19

Royal College of Obstetricians and Gynaecologists (RCOG) have released advice. This resource provides guidance for healthcare professionals working with pregnant women, but also gives Occupational health advice for employers and pregnant women during the COVID-19 pandemic. https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/

Today announced important advances in the battle against the global COVID-19 pandemic. As outlined in Pfizer’s five-point plan, the company has been collaborating across the healthcare innovation ecosystem to address the COVID-19 global healthcare crisis https://www.pfizer.co.uk/pfizer-advances-battle-against-covid-19

This national clinical trial aims to identify treatments that may be beneficial for adults hospitalised with confirmed COVID-19. Details available at: https://www.recoverytrial.net/

Have asked for people who’ve recovered from coronavirus (COVID-19) to donate blood plasma, as part of a potential clinical trial to help with the national effort against the virus. The trial, if approved, will tell us how effective convalescent plasma (plasma from people who’ve had coronavirus) is for treating coronavirus patients. If you would like to take part information is available at https://www.nhsbt.nhs.uk/how-you-can-help/convalescent-plasma-clinical-trial/

The aim of the project was to connect as many cancer centres across the UK as possible and keep a registry of patients who have an active cancer in order to understand and gain more knowledge about coronavirus in this special population. Available at: https://ecancer.org/en/video/8920-the-uk-coronavirus-cancer-monitoring-project?utm_campaign=automated-emails&utm_source=siteupdates-en-html&utm_medium=email#.Xp7E6dWnYdY.email

Two surveys were carried out in the UK to help inform the framing of priorities for mental health research in relation to the COVID-19 pandemic (see the main paper Panel 1 Methodology and Introduction). One was a survey by the research charity MQ: Transforming Mental Health and one by IPSOS MORI. The MQ survey achieved a remarkable response rate and the analyses of both surveys were completed in a very short time-frame. Many of the concerns reported in both surveys are related to anxiety, and that anxiety is being experienced as generalised by some and by others associated with issues such as work, money, getting food, fear of the virus, and keeping in touch. Isolation also features highly in both sets of responses. Social communication is seen as important in supporting good mental health. It highlights the vulnerability of those who have little contact with family or friends, and of those in abusive relationships. Available at:

https://acmedsci.ac.uk/file-download/99436893?utm_source=The%20King%27s%20Fund%20

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medium=email&utm_campaign=11479183_NEWSL_

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In light of COVID-19 there have been mitigation strategies implemented either nationally or within local hospitals in relation to the management of patients that are high risk such as those receiving cancer chemotherapy. We developed a survey to capture the views of healthcare professionals currently delivering cancer care around these strategies.  We believe it is essential to gain input from all professional groups involved in chemotherapy delivery to complete our survey to obtain a richer understanding of the changes to care.   

The survey is developed by an international interdisciplinary team with researchers from the Rapid Research, Evaluation and Appraisal Lab (RREAL), University College London and University College London NHS Foundation Trust. To obtain more information about this collaboration please contact  Pinkie Chambers (p.chambers@ucl.ac.uk).  

Research findings will enable a better understanding of the current global measures which will be important for future virus outbreaks should they ever occur

This study was approved by the University College London (UCL) Research Ethics Committee (REC). REC number 6862/005. 

We would appreciate any help in dissemination to medical and clinical oncologists.

Link to survey: https://opinio.ucl.ac.uk/s?s=67363

Access this free, online learning resource, developed by Skills for Health to support those working in the public sector, particularly key workers, to learn about COVID-19. This regularly updated guidance will ensure the workforce is well prepared to recognise and prevent the spread of the virus over the coming weeks and months, allowing for continuity of your best possible service delivery during these unprecedented times. This includes Statutory/Mandatory e-learning training, aligned to the UK’s Core Skills Training Framework, including Infection Prevention and Control. The introductory course is available here. https://www.skillsforhealth.org.uk/covid-19-course

British Association of Critical Care Nurses has produced a range of  Covid-19 Nurse Educational Resource materials here https://www.baccn.org/about/covid-19-nurse-educational-resource-centre/resources-1/

To support healthcare professionals during the current crisis, HEE have made available the Coronavirus e-Learning Programme free of charge. This programme brings together quality-assured content from Health Education England e-Learning for Healthcare, NHS England and NHS Improvement, and the World Health Organization (WHO). The programme is suitable for doctors, nurses, consultants, healthcare assistants, midwives and other allied healthcare professionals, including those who are returning to the workforce to help during the current crisis. You can access the content online – enabling you to refresh and extend your knowledge on critical themes and this is available here https://www.eintegrity.org/e-learning-healthcare-course/coronavirus.html

Has produced a library of useful information on how to sustain staff well being in the face of the pandemic. It is available here  https://www.ics.ac.uk/ICS/Education/Wellbeing

/ICS/Wellbeing.aspx?hkey=92348f51-a875-4d87-8ae4

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Daubman, B. R., Cranmer, H., Black, L., & Goodman, A. (2019). How to talk with dying patients and their families after disasters and humanitarian crises: a review of available tools and guides for disaster responders. Journal of International Humanitarian Action, 4(1), 10 https://doi.org/10.1186/s41018-019-0059-6

Duan, L., & Zhu, G. (2020). Psychological interventions for people affected by the COVID-19 epidemic. The Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(20)30073-0  

Hollander, J. E., & Carr, B. G. (2020). Virtually perfect? Telemedicine for covid-19. New England Journal of Medicine. https://www.nejm.org/doi/full/10.

1056/NEJMp2003539   

NHS Education for Scotland (2020) COVID-19: Difficult conversations – why we need to talk about dying. https://learn.nes.nhs.scot/28261/quality-improvement-zone/learning-programmes/scottish-quality-and-safety-sqs-fellowship-programme/difficult-conversations-why-we-need-to-talk-about-dying    

WHO (2020) Mental health and psychosocial considerations during the COVID-19 outbreak. [includes tips on communication]https://apps.who.int/iris

/bitstream/handle/10665/331490/WHO-2019-nCoV-MentalHealth-2020.1-eng.pdf

Zhou, X., Snoswell, C. L., Harding, L. E., Bambling, M., Edirippulige, S., Bai, X., & Smith, A. C. (2020). The Role of Telehealth in Reducing the Mental Health Burden from COVID-19. Telemedicine and e-Health. https://www.liebertpub.com/doi/full/10.1089

/tmj.2020.0068

BMJ Best Practice Guidelines include a section on COVID-19 accessible here- https://bestpractice.bmj.com/topics/en-gb/3000168#important-update

UpToDate are providing a good summary of the latest evidence relating to COVID-19, which are continuously updated and these are accessible here https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19

This page has lots of links and is continuously updated. Macmillan have reconfigured a new page and they will begin to add more tools and resources that professionals can signpost people to. People can access all they need via one link rather than just the coronavirus info. Some physical activity videos are also in place. Available here https://www.macmillan.org.uk/coronavirus

Has produced some guidance for infusions in the management of COVID-19 . In response to the latest COVID19 pandemic, hospitals are creating additional critical care bed capacity. Alongside this the administration of IV therapy will be integral to treating patients. There may be a shortage of infusion pumps and syringe pumps, this advice is offered from the National Infusion and Vascular Access Society (NIVAS) of the UK alongside the MEDUSA Online Injectable Medicines Guide. The link below will contain up to date information about injectable medicines during the COVID 19 outbreak and will be constantly updated. https://www.sps.nhs.uk/articles/use-of-gravity-infusions-and-bolus-injections-in-adults-during- covid-19/

Is a group of volunteers supporting local community groups organising mutual aid throughout the covid-19 outbreak in the UK. They focus on providing resources and connecting people to their nearest local groups, willing volunteers and those in need. We recognise that injustice doesn’t affect everyone equally and whilst we’re all at risk of covid-19, there are some people who are more vulnerable and need greater support from the community. The basic idea is to coordinate care efforts for people who are self-isolating, especially if they are part of a more at risk demographic including the elderly, disabled and people with other pre-existing health issues. We’re also trying to offer support to those people who are feeling most isolated/anxious throughout the pandemic. For people with mental health conditions this scale of panic can be overwhelming and so community support is vital. They are a new group who have set up over the past few days. As such are still working out how to most effectively organise together and make our information accessible. You can search by postcode to find local services for patients. https://covidmutualaid.org/local-groups/

The NHS Guidance on Oncology patients and COVID-19 which was produced last week https://www.england.nhs.uk/coronavirus

/publication/specialty-guides-cancer/  has now ben supplemented by the ‘COVID-19 rapid guideline: delivery of systemic anticancer treatments’. This is an important document which re-iterates the previous document but outlines the procedure for prioritisation of SACT and defines the national prioritisation categories for SACT. The document also outlines other good practice, defines the role of MDT working in SACT prioritisation and stresses the importance of communication with patients with regard to this. UKONS was consulted and contributed to this advice and it is available here:  https://www.nice.org.uk/guidance/ng161

The Mental Health Foundation have produced some excellent guidance on how to safeguard your mental health in these trying circumstances. There are some great tips here.  https://www.mentalhealth.org.uk/publications/

looking-after-your-mental-health-during-coronavirus-outbreak

Have also produced a list of resources

Following a very recent admission to hospital, one of our board members has produced the following list for our patients who might find themselves admitted during the current situation. Prepare a ‘Grab Bag’ of essential items in case you need to go into hospital. Make sure you take disposal items with you if you have them. Take

1. Usual Medication
2. Tissues – if you have suspected COVID-19 you may not be able to leave the bed-space and it is wise to have a supply of tissue and toilet roll for your own use.
3. Bottles of water. Bring these for your own use as hospitals may not have and endless disposable cups. Sparking water is refreshing as any oxygen really dries the mouth.
4. Lip-Balm – lips can dry in hospital. Nebulisers and oxygen can make the situation worse.
5. Disposable toothbrush and toothpaste
6. Disposable Washlets – to wipe hands and face and freshen up if needed. Staff are likely to be very busy
7. Mobile phone and charger – will be only way to keep in touch with family
8. Pen and Paper – for important information you do not want to forget
9. Loose fitting night clothes – two sets will be enough. You may not be able to change as often as you would do normally. Hospitals can also provide gowns and other items.
10. Plastic bags – two small bags for your rubbish, two larger bags to double bag laundry
11. Don’t bother taking a towel and best to take disposable slippers that you can discard at the end of the stay

It is likely, and desirable that you should try and leave hospital as soon as it is safe to get home. Staff will give you advice on this.

has lots of links and is continuously updated. Macmillan have reconfigured a new page and they will begin to add more tools and resources that professionals can signpost people to. There are also some physical activity videos that are also in place. Available here https://www.macmillan.org.uk/coronavirus

This is a sound principle which has resulted in many hospitals reducing non-essential visits to the hospital and utilising telephone or video-conferenced clinics instead. Patients should be informed that this is likely to happen. Inevitably specialist cancer nurses will be involved in these clinics and these need to be captured and documented accurately. In terms of the work of oncology nurses, Pre-Chemotherapy Clinics are generally designated as important but not essential. Much of this work can be done over the telephone or via video link. UKONS have produced a film to support patients and explain the contents of the CRUK ‘Your Cancer Treatment Record to accompany these clinics.

Patients receiving chemotherapy have been encouraged to reduce the social contact they have with others. The Government advice re social distancing can be found here https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults?fbclid=IwAR2JcGxozkQ4zcvsMYcjmBY3WIHsYy-HS_cYwMWvQu7sFDaOc92HyCLbTDY

Website can be found here as it collates lots of information for primary care and also is very good at bringing together information and guidance from all of the four nations. https://primarycarepathways.co.uk/covid19

(12.4.20) Latest PPE guidance from the UK government. Available at: https://www.gov.uk/government/collections/

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Hospital discharge service requirements (9.4.20). This sets out how health and care systems and providers should change their discharging arrangements and the provision of community support during the coronavirus situation. Available at:https://www.gov.uk/government/publications/

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Endorsed by NHS England. These interim treatment regimens are based on clinical opinion from members of the Chemotherapy Clinical Reference Group and cancer pharmacist and endorsed by NHS England and NHS Improvement. The responsibility for using these interim treatment regimens lies entirely with the prescribing clinician, who must discuss the risks and benefits of interim treatment regimens with individual patients, their families and carers. All patients who start on an interim treatment during the COVID-19 pandemic should be allowed to continue the treatment until they and their clinician jointly decide it is appropriate to stop or to switch to a different treatment. These treatment options can be viewed here https://www.nice.org.uk/guidance/ng161/resources

/interim-treatment-change-options-during-the-covid19-pandemic-endorsed-by-nhs-england-pdf-8715724381

These recommendations should be used as guidance for prioritising the various aspects of cancer care in order to mitigate the negative effects of the COVID-19 pandemic on the management of cancer patients. Available at: https://www.esmo.org/guidelines/cancer-patient-management-during-the-covid-19-pandemic

(7.4.20) available at:  https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0239-Specialty-guide-Essential-Cancer-surgery-and-coronavirus-v1-70420.pdf

Critical care in adults (9.4.20) Latest update available at: https://www.nice.org.uk/guidance/ng159

Acute use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19 (14.4.20) available at: https://www.nice.org.uk/advice/es23/chapter/Key-messages

Issue joint statement on Facilitating compassionate care for patients dying with COVID-19. Available at: https://www.baccn.org/about/covid-19-nurse-educational-resource-centre/latest-news-and-updates/

The science says yes. Written: 13 Apr 2020 by Professor Trisha Greenhalgh OBE and Jeremy Howard, available at: https://www.fast.ai/2020/04/13/masks-summary/

Some of the content relating to cancer and the pandemic may be of a sensitive nature to people living with cancer and the general public, so Macmillan created a safe area COIVD-19 related for Cancer professionals on the Macmillan ‘Learnzone’ site. There is an enrolment key that will be needed to access the site and the link is as follows: https://learnzone.org.uk/coronavirus/ . To access the resources you will need a Learnzone account. If you do not already have a ‘Learnzone’ account, it’s easy to create one on the site but here is the link to register https://learnzone.macmillan.org.uk/login/signup.php?_ga=2.118657033.1631791940.1586166299-1936566431.1569233690  

Your first access of each set of resources will require an enrolment key. For every set of resources, the key is ‘covid19’.  If you do run into any issues with the site, you can contact the Macmillan information team by clicking the Support button in the top right-hand corner.

  Macmillan hope that the resources will be of help, and some benefit to our professionals, but they seek to gain feedback on what else can be added, so regular updates will be added to the learn Zone site.

 Macmillan has resources for professionals relating to

 Emotional health and Wellbeing

  Cancer and Covid19: including treatment info for nurses and AHP’s

  End of Life and bereavement

  Communication skills and difficult conversations

  Resources you can use to support your patients

  General and other resources

And this has been passed to all NHS Trusts via a letter which is available here

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0119-_Maintaining-cancer-services-_-letter-to-trusts.pdf

The letter outlines how Trusts are expected to continue to deliver cancer services with emphasis on continuing essential and urgent cancer treatments. Cancer specialists should discuss with their patients whether it is riskier for them to undergo or to delay treatment at this time and where referrals or treatment plans depart from normal practice, safety-netting must be in place so that patients can be followed up. The letter also suggests that urgent consideration should be given to consolidating cancer surgery in a COVID-free hub, with centralised triage to prioritise patients based on clinical need.

This is the latest guidance from NHSE on the use of PPE. This follows a recent update  https://www.gov.uk/government/news/new-personal-protective-equipment-ppe-guidance-for-nhs-teams

To support Trust written and verbal communications with patients and healthcare professionals regarding cancer and COVID-19. Please note that this repository of documents is advisory only and intended as a useful resource for trusts to review and tailor locally during the coronavirus outbreak. It is available on the UKONS website here. https://ukons.org/site/assets/files/1134/

trust_cancer_covid19_letter_script_templates

_final.pdf

(2.4.20) Public Health England (PHE) has worked with NHS England and NHS Improvement, and the Devolved Administrations to review the UK’s infection prevention and control recommendations for COVID-19. Latest advice available at: https://www.gov.uk/government/publications/wuhan

-novel-coronavirus-infection-prevention-and-control/updates-to-the-infection-prevention-and-control-guidance-for

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(1.4.20) the purpose of this guideline is to maximise the safety of patients who need haemopoietic stem cell transplantation and make the best use of NHS resources, while protecting staff from infection. It will also enable services to match the capacity for transplantation to patient needs if services become limited because of the COVID 19 pandemic. Available at: https://www.nice.org.uk/guidance/ng164

(including at the end of life) in the community. The purpose of this guideline is to provide recommendations for managing COVID 19 symptoms for patients in the community, including at the end of life. It also includes recommendations about managing medicines for these patients, and protecting staff from infection. Available at: https://www.nice.org.uk/guidance/ng163/chapter/8

-Managing-medicines-for-patients-with-COVID-19

During the COVID-19 pandemic (2.4.20) Published Online, https://www.thelancet.com/journals/lanonc/

article/PIIS1470-2045(20)30217-5/fulltext

Current information and resources to its members and the larger oncology community to help ensure that individuals with cancer receive high-quality care. ASCO has compiled a wide range of resources to support clinicians, the cancer care delivery team, and patients with cancer. Available at: https://www.asco.org/asco-coronavirus-information

Developed in 48hrs to support Trusts to enable virtual visits with Patients https://www.thehtn.co.uk/2020/04/18/app-developed-in-48-hours-to-support-2-trusts/

Some psychological self-help apps are available to all NHS staff for free via NHS England. these include Unmind, Headspace, Sleepio and Daylight.  NHS England and NHS Improvement announced the first in a series of psychological support mechanisms for all NHS staff during the COVID19 outbreak, recognising the importance of looking after your own health and wellbeing, whilst supporting patients and your family Additional self-help apps and support will be available over the next few weeks.

 Unmind:

Unmind is a mental health platform that empowers staff to proactively improve their mental wellbeing. Using scientifically-backed assessments, tools and training you can measure and manage your personal mental health needs, including digital programmes designed to help with stress, sleep, coping, connection, fulfilment and nutrition.

They are offering free access to NHS staff until the end of December 2020, active now.

How NHS staff can get access

Go to https://nhs.unmind.com/signup and sign up with your NHS email address or download the Unmind app from your appstore  -  your organisation name is NHS.

Headspace:

Headspace is a science-backed app in mindfulness and meditation, providing unique tools and resources to help reduce stress, build resilience, and aid better sleep. They are offering free access to all NHS staff with an NHS email address until 31 December, active now.

How NHS staff can get access

Go to https://www.headspace.com/nhs  and select clinical or non-clinical staff to start enrolling

You will need to use your NHS email address to sign up

Sleepio and Daylight (developed by Big Health):

Sleepio is a clinically-evidenced sleep improvement programme that is fully automated and highly personalised, using cognitive behavioural techniques to help improve poor sleep. Free access to Sleepio for all NHS staff is active now until 31 December.

Daylight is a smartphone-based app that provides help to people experiencing symptoms of worry and anxiety, using evidence-based cognitive behavioural techniques, voice and animation.

Free access to Daylight is active now until 31 December.

How NHS staff can access Sleepio

Visit http://sleepio.com/redeem  on your laptop or desktop computer and enter redeem code NHS2020 and sign up for an account using your name and email address. You can then complete the sleep test

How to access Daylight

Click on the following linkhttp://trydaylight.com/nhs-staff  and answer a few short questions to tailor the programme to you. Then sign up for an account using your name and email address. You can also download the Daylight smartphone app (search 'Daylight - Worry Less').

A yoga app is being made available to NHS staff for free until 1st July: https://www.downdogapp.com/healthcare

The FIIT home workout app gives NHS staff access to Pilates, Yoga, strength and cardio workouts.  FIIT is offering Premium memberships to all NHS staff - for free. https://fiit-squad.typeform.com/to/UFEfqW?utm_campaign=unknown&utm_

source=shortlink&utm_medium=referral  

To access Fitness Studio, visit the NHS website https://www.nhs.uk/conditions/nhs-fitness-studio/

Yoga with Adrienne has multiple Youtube videos for all levels from 10 mins to 45 mins. This could be good for necks/backs while WFH. There are some practices for reducing stress, anxiety, anger etc too.https://www.youtube.com/user/yogawithadriene  

The Body Coach lots of video for short intense workouts for all skill levels, including low impact ones. He has also started doing ‘P.E.’ at home lessons for children and adults to take part in, live and daily from 9am on Youtube https://www.thebodycoach.com/blog/pe-with-joe-1254.html

This is a national project which allows oncologists to report the case details and outcomes of people with a cancer diagnosis who also contract COVID-19. Details of the project can be found here https://ukcoronaviruscancermonitoring.com/. A visual representation of data from the first cohort of oncology patients in the UK can be viewed on Twitter via @UKCORONACANCER.

Macmillan Video Resources for Primary Care ‘Courageous Conversations’

We know that GPs and other health professionals will be entering into discussions around end of life care with patients and families which will have been made more complex and distressing by the current situation. As with  Macmillans other  ‘Courageous Conversations’ video resources, these recordings are vehicles for learning and should not be interpreted as examples of perfect consultations but rather to demonstrate some useful strategies, words and phrases.

These new resources consist of recordings designed to replicate telephone and Skype calls and illustrate the following scenarios:

Scenario 1: Older patient with co-morbidities but currently well, GP calls phones to discuss advance care planning. Available here https://vimeo.com/405774487

Scenario 2: Patient at home with multiple co-morbidities, elderly and COVID symptoms, in Skype conversation with GP. Available here https://vimeo.com/405875369

Scenario 3: Daughter of a patient in a care home phones her mother's GP on learning that her mother has COVID-19. Available here https://vimeo.com/405775809

Scenario 4: Follow up phone call from GP to patient with advanced bowel cancer and liver metastases. Available here https://vimeo.com/405776765

The NHS mental health hotline for NHS staff delivered by Hospice UK and Samaritans has been announced today. It is open 07.00 to 23.00 seven days a week   Phone 0300 131 7000 or Text FRONTLINE 85258. There is also a video developed by UCL  https://youtu.be/WFWvkjJ755Y

This article will cover the importance of sleep and the consequences of sleep debt, while showing how to build a sleep routine as a learner.

In the US the Oncology Nursing Society has produced guidance on how oncology nurses should be deployed. Hospitals and cancer centres are facing unique challenges in staffing and are redeploying staff to other units. Factors contributing to decisions about temporary reassignment of oncology staff outside of the oncology unit or ambulatory department or discussed in the document which is available here https://www.ons.org/oncology-staff-assignments-covid-19

The Covid-19 situation is full of uncertainties. Leaders are struggling to find the right solutions as the context changes almost hour by hour. Now more than ever, leaders need to draw upon all available resources, most particularly their people, utilising the collective intelligence of experience and knowledge while adapting and revising solutions as the situation unfolds. The Kings Fund have produced a blog around why compassion is important when leading teams during the pandemic. This is available here https://www.kingsfund.org.uk/blog/2020/03/covid-19-crisis-compassionate-leadership

As a result of the Coronavirus pandemic British Psychological Society Covid19 Staff Wellbeing Group. Available at:https://www.bps.org.uk/sites/www.bps.org.uk

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Mental health support from NHS England https://www.nhs.uk/oneyou/every-mind-matters/

On this page you can find the articles related to COVID-19 disease in the context of cancer care management as published in the ESMO flagship journal, the Annals of Oncology and the ESMO Open. Available at: https://www.esmo.org/covid-19-and-cancer/covid-19-and-cancer-care-in-the-esmo-journals

On shielding for vulnerable patients (17.4.20) available at:  COVID-19: guidance on shielding and protecting people defined on medical grounds as extremely vulnerable

To more frontline workers (17.4.20),news from www.gov.uk available at: https://www.gov.uk/government/news/government-to-extend-testing-for-coronavirus-to-more-frontline-workers?utm_source=7985db27-978c-4d78-b1e5-1071a367576&utm_medium=email&utm_campaign=

govuk-notifications&utm_content=daily

Local Government Minister Simon Clarke today (17.4.20) wrote to all councils in England to ensure that family members can attend the funerals of their loved ones and that the wishes of the deceased are respected during this pandemic. Available at: https://www.gov.uk/government/news/government-sets-out-plans-to-ensure-bereaved-families-can-attend-funerals-during-pandemic?utm_source=d656ace9-b375-4be5-bda2-34c83a5afdcd&utm_medium=email&utm_campaign=

govuk-notifications&utm_content=daily  

Guidance for step down of infection control precautions within hospitals and discharging COVID-19 patients from hospital to home settings (18.4.20) available at: https://www.gov.uk/government/publications/covid-19-guidance-for-stepdown-of-infection-control-precautions-within-hospitals-and-discharging-covid-19-patients-from-hospital-to-home-settings?utm_source=2af98d83-5ac2-484d-8162-0cf5021c12a4&utm_medium=email&utm_campaign

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Modern Compassionate Care in the Covid-19 Pandemic, Wakam, G et al (2020 available at: https://www.nejm.org/doi/full/10.1056/

NEJMp2007781

(including at the end of life) in the community: summary of NICE guidelines BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1461  (Published 20 April 2020) Cite this as: BMJ 2020;369:m1461

Yeoh, C et al, Anesthesia & Analgesia: April 15, 2020 - Volume Publish Ahead of Print - Issue –   

(2020) Al-Quteimat, Osama; Amer, Amer Mustafa, American Journal of Clinical Oncology: April 16, 2020 - Volume Publish Ahead of Print - Issue - doi: 10.1097/COC.0000000000000712

(2020). Coronavirus resource center. https://coronavirus.jhu.edu/map.html

(2020) Karim Hussien El-Shakankery K et al, British Journal of Cancer https://doi.org/10.1038/s41416-020-0843-5  

A Double Blow for Oncologists (2020) Sahu et al, JCO Oncology Practice available at https://ascopubs.org/doi/full/10.1200/OP.20.00167