ABN note to Neurology Clinical Directors. URGENT: Social isolation for high risk neurology patients
23 March 2020
Dear Clinical Directors
You will be aware that the government is developing plans to support 1.5 million 'high risk' patients who have been advised to enter self-isolation for 3 months or more. These patients will be offered guaranteed medication and there will be support for food deliveries etc. The precise plans are in development but no doubt will be well publicised in due course.
The ABN has developed guidance on patients who should be considered to be at high risk. Broadly, this includes immunosuppressed patients, those with bulbar and respiratory muscle weakness and those with other factors, such as cardiac disease. The enclosed guidelines should help identify these patient groups.
Some patient groups, such as MS on DMTs or MND will be easier to identify than others. A Prednisolone dose of less than 20mg per day is not considered high risk. Actively managed patients in neurology clinics are more likely to be at risk than those seen infrequently or managed by GPs on shared care agreements unless there are additional factors present (see guidelines document).
The purpose of this email is to ask that you direct your consultants to urgently identify the patients in the high risk category, using the ABN Guidelines. Please use their NHS numbers so that the data can be used nationally. A register of high risk patients in each service will greatly facilitate support of this group.
The process for what to do with this data is under development. Whether the patient contact will be directly from NHSE or from neuroscience centres is under discussion. The resource implications with possible resulting delays are well known to the decision makers. At this stage however, identifying the patients is the top priority.
Further information will be sent through as it becomes available. The specialist societies such as ABN have been asked to disseminate this request due to their close relationship with neuroscience centres. The leadership of the ABN with, and via the RCP is in close contact with the Chief Medical Officer's department, and great efforts are being made to be as effective as possible.
The Devolved Administrations are making their own arrangements but are in close contact with NHSE.
Jon Sussman, Cath Mummery & Chris Kipps
Honorary Secretary; Chair, Services Committee; Chair, Quality Committee