COVID-19 Vaccination e-learning programme

Health Education England e-Learning for Healthcare has worked in partnership with Public Health England and NHS England and NHS Improvement to develop the COVID-19 Vaccination e-learning programme.  The e-learning programme is designed to provide the health and care workforce involved in the national COVID-19 vaccination programme with the knowledge they need to confidently promote high uptake of the vaccine and deliver the vaccine programme effectively.

The programme currently consists of one core knowledge session, which covers subjects including vaccine eligibility and legal aspects, and an accompanying multiple-choice assessment session.  All those undertaking this e-learning should complete the core knowledge session as this is designed to provide essential knowledge about COVID-19 and the key principles of vaccination needed to deliver the vaccine.

                           

The e-learning sessions describe the national COVID-19 vaccination programme for England. Most of the information in the sessions will be relevant for those involved in the programme throughout the UK and Crown Dependencies. However, those undertaking the programme in Northern Ireland, Scotland, Wales and the Crown Dependencies should be aware that some details as to how the programme will be delivered may be different. Vaccinators should therefore ensure that they refer to any country-specific information available, so they are familiar with the details of the programme for the country they are practising in.

This e-learning programme provides theoretical training.  Practical training in vaccine administration, and assessment and sign-off competency is also required before administering the COVID-19 vaccine.

Learners should also complete the vaccine specific session(s), when available, which will provide more detailed information about the vaccine(s). The assessment sessions should be completed after each knowledge session.  More vaccine-specific sessions will be added as and when more COVID-19 vaccines become available.

Additional, complementary, e-learning sessions including Basic Life Support, anaphylaxis and statutory and mandatory training are available to support vaccinators’ training and education.

For more information about the COVID-19 Vaccination programme, including details on how to access, visit the e-LfH website. (or click on the image above). 

Please note, this information was copied directly from the e mail sent by the Directorate of Innovation and Transformation, Technology Enhanced Learning, e-Learning for Healthcare.

Good Practice Guidance for a Travel Health Service

Introduction

For travel health or travel medicine - my area of specialist practice, the impact of COVID-19 has been devastating for different reasons for those working in this field full time.  In the main people have stopped travelling so there are very few travellers to see who would have previously required advice and where there is demand, this is currently largely for COVID testing for travel.  Even if you undertake travel health as a small part of your daily workload, as many will in General Practice, there is little demand.  Jobs are at risk in many related areas for travel health (e.g. the specialist private travel clinics, staff in vaccine divisions of pharmaceutical companies).  Vast stocks of vaccines approaching their 'expire by date' will be wasted, a huge economic loss, and I've heard of no real solution to this and certainly no compensation unless the owner has specific valid insurance.  Specialist travel services operating in the private sector have the skills to immunise with all the required knowledge and yet to date, I've seen little co-ordination to consider using this taskforce to assist in the massive operation needed to administer the NHS flu vaccination campaign or to help in the future campaign to vaccinate the millions of people when a COVID-19 vaccine hopefully becomes available. 

What is the Faculty of Travel Medicine?

The Royal College of Physicians and Surgeons of Glasgow are the only College in the Northern Hemisphere to have a Faculty of Travel Medicine (FTM).  We are a small group of subject experts in travel medicine. The mission of the FTM surrounds concern for education and standards.  More details can be found here. If you become a Fellow, Member or Associate of the Faculty you are awarded a post nominal qualification, signifying your level of expertise, but entry must be demonstrated to allow this.  We also have another category of Affiliate, which is open to anyone interested in the subject.  The fee for this is far smaller but allows the individual to benefit from the educational opportunities the Faculty provides.  

This was our stand at the RCN/NaTHNaC conference in February 2020

I referred in the last paragraph to the FTM as 'we'.  This is because I was involved in the development of this body in 2011 - the Faculty came into existence in 2012.  I am the fifth Dean (the Leader of the group) but I held many other positions before this and I am the first nurse and first female to become the Dean, which spans a term of three years.  We all work in our roles unpaid, but this is standard practice in any body such as a medical Royal College because the work is about having a passion to utilise one's experience to develop the subject, support other practitioners and improve standards of care for our patients.  I'm immensely proud to hold this role and since COVID-19 resulted in losing all my face to face teaching work, I've focussed on FTM work full time.  The FTM comprises doctors, pharmacists and there are many nurses who belong and have qualifications in the subject.  On International Nurses Day this year, I put a photo together with images of some of them - I'm so proud to be part of this group and many of them are active in the FTM work!  

NEWS !  Good Practice Guidance for Providing a Travel Health Service

So it was with immense pleasure that I announced a document at our AGM last Friday, 'GOOD PRACTICE GUIDANCE FOR PROVIDING A TRAVEL HEALTH SERVICE'.  It may seem a strange time to launch such a publication but this has actually been in development for two years before any of us had any idea what was around the corner!  Standards of care for travel health in the UK are variable.  In the introduction of the document it states 'The FTM considers the most important aspect of delivering travel health care is not which professional group delivers the care, but that each person doing so exceeds the minimum standard of practice and meets the health needs of the traveller'. 

Click on the image above to access the document. or here

Overview of content 

The document sets out expected standards of practice in four key areas

1. Service Delivery
2. Operating/Facility Requirements for a Travel Service
3. Assurance and Governance of Travel Health Services
4. Recomendations for the Practice of Travel Medicine 

The fourth section is supported by two appendices to further enhance standards and training 

• Appendix B provides an example of a practitioner assessment tool for competency in travel health
• Appendix C lists the training requirements in travel medicine. 

Other helpful reources.  

At the end of the document is a 12 page 'booklet' of really useful resources followed by a patient leaflet to help the traveller understand WHAT they should expect to experience within a travel health consultation.  This patient leaflet  is also available as a single downloadable item.  

Other helpful tips

If you download the document, many features have been added to help you navigate the 52 pages. All the links in the index both on page 5 and on page 39 have been hyperlinked to the sections within the publication to make it easy to get to the sections without having to scroll down all the time.  And if you click on any resource that has a weblink, if you press Ctrl then click the link, the page should open in a separate tab if you're using browsers such as Google Chrome or Internet Explorer.  

The competency tool is also available as an editable Word document so that you can keep a 'living' and 'virtual' record of the competencies you develop.  This is especially important for new learners but also useful to use as you develop your skills and determine the further training and learning skills you need.    

Conclusion 

Despite the current Global Pandemic, many similar situations have happened in the past and in due course travel will be very popular again, indeed it may be busier than ever and I hope then travellers will be increasingly more aware of the advice they need to take to protect their health.  So to prepare for that situation, it is important that practitioners are properly trained and prepared.  This document supports this aim, to ensure the future safety of our travellers is catered for and practitioners practice safely within their professional codes of conduct.  

31st National Immunisation Conference

The 31st National Immunisation Conference for Healthcare Workers has been led by Dr David Baxter over many years and has always been held on the first Friday of December in Manchester.  However, this year it's going virtual and is provided free of charge.  It always attracts excellent and well known speakers.  

The meeting is advertised on the Clinical Vaccinology website HERE or ALTERNATIVELY and to save time, you could download the application form HERE and then e mail it directly to Nicole.Beveridge@stockport.nhs.uk 

The meeting also has a poster competition element to it. To download a copy of this information click HERE. 

I intend to register so see you there virtually on Zoom!  

EDUCATIONAL OPPORTUNITIES in Travel Medicine

As we start to return to a new type of normal in our lives, there has been an increased interest in travel medicine education so I thought I would lay out in this blog some activities I've been up to over the last few months - mostly within my role as Dean of the Faculty of Travel Medicine (FTM) of the Royal College of Physicians and Surgeons of Glasgow.  Much of this is for those practising the subject, but if you're new, you may also find it very interesting to explore!

TRAVEL HEALTH UPDATES - this will be a series of one hour webinars (plus extra time for questions) that I'll be chairing and speaking at along with some travel health specialist nurse colleagues and friends on four consecutive Tuesdays in November (17th and 24th) and December (1st and 8th) but all events will be available afterwards to catch up on if you miss one.  Each session will cover different topics and resources will also be provided.  Cost for the entire series £25 for FTM members and £40 for non members.  See HERE.
Please note: If you think your organisation may be interested in a block booking there are also corporate rates so please contact me

ONLINE CONFERENCE - Future Travel Medicine Practice in the Wake of COVID-19 on 6th November 2020 from the FTM.  This event has an amazing line up of speakers and the delegate rates are very low at £25 for FTM members and £35 for non members.  Please check out the programme HERE  or you could download it directly from here 

TIP - to become an Affiliate member of the FTM costs £30 and there are many benefits.  If you decided to attend the conference and the travel health updates, having joined as a member, it would mean the whole package would cost a total of £80.  To read more about joining see HERE


EMPORIATRICS is an education hub of resources that comes out 6 monthly from the FTM as a membership benefit.  I create this, supported by College staff, some great authors and a very supportive editorial team.  This is usually a membership benefit but due to COVID-19 the College made this open access for the current edition - explore HERE

NEW TO TRAVEL HEALTH course 
My own two day training course which is held face to face at the UCH Education Centre in London has been cancelled because the centre has closed to all outside trainer bookings until April 2021.  However I am developing the course into a digital format with some follow up real time training online after the e learning has been undertaken.  This is taking time to create the high standards and quality I always want to maintain and I anticipate it will be ready later this year.  Please check out the new to travel course webpage in due course - accessed here and for further information you are welcome to contact me here.  

Happy St George's Day!

I decided to post a blog that's been fun to create because I've had a good 24 hours - need a bit of light relief in these hard times.  Travel medicine was the first thing in my career that came near to the excitement my time as a ward sister of a female medical ward (Ogle) at St. George's Hospital in Tooting evoked.

But yesterday I received an e mail from Mandy Galloway, the Editor of Practice Nurse Journal.  She had received an e mail from Practice Nurse Manager Oonagh Atkinson who wrote to say that she had subscribed to the journal since 1993 and she wanted to give thanks as she recognised the journal as a superb resource which had helped her to keep up to date with current practice nursing issues and learn about new areas.  She also said the following!  I have particularly enjoyed reading Jane Chiodini's Travel Health Updates. I worked as a student nurse on Ogle Ward at St George's Hospital in 1983 where Jane was the ward sister. She was a wonderful ward sister and mentor then and I have found her articles and resources excellent.  And I remember Oonagh so well too, I saw her in a Holiday Inn near Surrey University where I was delivering a study day in 2010.  I also have a photo of her in Il Carretto's in Streatham where we went for a leaving meal for one of the Staff Nurses who was leaving, the memory of that event is strong and the amazing 'chicken kievs' served up as well at the restaurant, sadly no longer trading!

Ogle was a 25 bedded Nightingale Ward, it was very busy and the work heavy but I loved it so much.  Well that then set up an e mail exchange with Beverley Bostock who is the Editor in Chief of Practice Nurse Journal who had also trained at St George's and it turned out we had many people we know in common, including Ruth Amartey (nee Holgate) who is an Advanced Nurse Practitioner and Clinical Lead for Nursing  in the Waltham Forrest Training Hub (CEPN) and with whom I've provided travel health study days for a number of years now!  That led me to contact two friends on FaceBook who were staff nurses on Ogle and a little chat then pursued with them.  And all this discussion happening on St. George's Day!  So if you knew me in the past (and I've met a few on study days) or you trained at St George's and have anything to share then perhaps e mail me via my website - I'd love to compile some historical memories together.

 In the nurses office of Ogle Ward writing up the Kardex!  

I was featured in a careers magazine - right hand pictue, middle row! My twin nephews picked the mazine up in the school library and were excited to see their Aunt on the cover - they are now 40! 

After a year working at St George's as a Staff Nurse one was awarded with a 'red belt' and a St George's buckle as a reward.  It was oval with George and the dragon in solid silver, mine had the Queen's Silver Jubiliee hallmark on it.  Loved the uniforms of those days although the hats were a nightmare to make.  I happened to have a 'flair' for them unfortunately - they had to have five pleats and three crowns on the top, with a very specific bow completing the work at the back!  I often got 'landed' with requests to make them for lots of other friends and colleagues - of course I did, but many would use them for weeks on end because they were so tricky to make - not sure infection control was a term we knew 'on our heads' but my hair was washed daily! We used to have some Royal Masonic nurses living in the nurses home, now their hats were even more complex!  I used to sing in the London Choirs for the Malcolm Sargeant Cancer Fund for Children at the Royal Festival Hall each Christmas - all the hats were on display there. The Bart's hats were my favourite!  

and lastly, my husband always buys me a rose on St George's Day - 

here's an image I shared earlier on Instagram!  

HAPPY DAYS and HAPPY ST.GEORGE'S DAY!

What a March

COVID-19 has moved at such a fast pace, travel medicine seems a very low priority and I struggle to find much news to put on my FaceBook page about it really.  I also realise that this is the only subject I've blogged about this year.  I've now created a webpage of resources to take you to key sites for information, but to be honest, it's very hard to keep up with it all and I've reduced the time I listen to the news - I was finding it detrimental to sleeping well and coping with day to day work. 

So although I'm fully aware of the situation, my usual news sources have changed.  I wake to the headlines on Radio 4 at 6.30am each day, continue to refer to the Government resources, watch the daily Goverment briefings if possible and if not, catch a summary on the 6pm news. 

I'm still blogging every two weeks (althugh as time progressed, they became a little less frequent) for the Royal College of Physicians and Surgeons of Glasgow in my role as Dean of the Faculty of Travel Medicine.  They have a great COVID-19 landing page of resources here and my blogs can be found as follows:  31st January 2020,  14th February 2020,  28th February 2020, 13th March 2020  27th March 2020    10th April 2020  24th April 2020  15th May 2020   8th June 2020

Click the image below ot access the COVID-19 resources page on my website or here.

COVID-19 Update

In just one month so much has happened and it's a challenge to keep up to speed.  I've been writing a regular blog in my position as Dean of the Faculty of Travel Medicine of the Royal College of Physicians and Surgeons of Glasgow so I'm going to defer you to these and then below itemise some of the the most useful resources for us in our day to day jobs.  The clear messages from the Government right now are correct hand washing hygiene and etiquette around coughing and sneezing.

Here are the blogs from 

31st January

14th February

28th February 

here are a few key or interesting resources for COVID-19 - but not an exhaustive list!

• PHE & DHSC COVID-19: guidance for health professionals  This includes guidance for primary care and travel advice.
• Public Health Matters Q&A webpage.  Coronavirus – what you need to know here
• NHS page designed to help clinicians- doctors, nurses, dentists, opticians and other healthcare colleagues – deal with coronavirus (COVID-19) here
• WHO collection of resources here 
• WHO Coronavirus disease (COVID-2019) situation reports here
• CDC collection of resources here 
• Very interesting series of presentations - Royal College of Physicians COVID-19: An expert update for doctors on 12th February here 
• NHS Overview Coronavirus (COVID-19) for the public here
• NHS resource: How to wash your hands here 
• PHE Coronavirus (COVID-19) resources here

For children

• CDC collection of handwashing posters including some for children here
• The CBBC Newsround has published a short video with Dr Chris and Dr Xand - Coronavirus: Why it might not be as scary as it sounds   I think we should all adopt the elbow shake! 

Novel Coronavirus (2019-nCoV)

The purpose of this (rather long sorry!) blog is to lead you to key resources as the developments of novel coronavirus (2019-nCoV) unfold.  Please note, as new resources become available I will post these updates right at the bottom of the page under the heading, Update on New Resources.  

Background

On 31 December 2019, the World Health Organization (WHO) was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China. A novel coronovirus was identified as the cause and was named Coronovirus (2019-nCoV).  

Coronaviruses are a large family of viruses, some cause mild illness, such as the common cold but others can result in more severe disease such as Middle East respiratory syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).  Generally, coronavirus can cause more severe symptoms in people with weakened immune systems, older people, and those with long term conditions like diabetes, cancer and chronic lung disease.  The main symptoms reported for novel coronovirus (2019n-CoV) have been fever, cough or chest tightness, and dyspnoea. While most cases report a mild illness, severe cases are also being reported, some of whom require intensive care and some deaths have occurred. 

World Health Organization updates

The WHO publish a daily situation report and on 30^th January 2020 recommended that the interim name of the disease causing the current outbreak should be “2019-nCoV acute respiratory disease” (where ‘n’ is for novel and ‘CoV’ is for coronavirus).  At this time there were 7818 cases confirmed globally of which 7736 were confirmed in China.  Of these, 1370 were severe and 170 deaths had occurred.  Outside of China there were 82 cases in 18 countries.  The report provides a global map of the countries, territories or areas with reported confirmed cases of 2019-nCoV and a surveillance table of the numbers within each location. 

However, this is a rapidly changing picture and on 30^th January 2020 the WHO convened the second International Health Regulations (IHR) Emergency Committee on novel coronavirus in China.  The Committee stated they believed that ‘it is still possible to interrupt virus spread, provided that countries put in place strong measures to detect disease early, isolate and treat cases, trace contacts, and promote social distancing measures commensurate with the risk. It is important to note that as the situation continues to evolve, so will the strategic goals and measures to prevent and reduce spread of the infection’. As a result the Director-General declared that the outbreak of 2019-nCoV constitutes a Public Health Emergency of International Concern (PHEIC) and accepted the Committee’s advice and issued advice as Temporary Recommendations under the IHR to the People’s Republic of China, to all countries and then to the global community – full details can be viewed here 

A key page of very helpful resources from the WHO provides advice on protecting yourself, travel advice, myth-busters, situation reports and technical guidance.  It is suggested users visit it daily. The image below is one of the mythbusters, click on this image to view more.

News from the United Kingdom

In the UK our four Chief Medical Officers issued a press release on 30th January 2020 explaining in light of the current situation they considered it prudent for their governments to escalate planning and preparation in case of a more widespread outbreak.  For that reason, they advised an increase of the UK risk level from low to moderate clarifying that this didn’t mean they thought the risk to individuals in the UK had changed at this stage, but that government should plan for all eventualities.  To read in full see here

On the morning of 31^st January 2020, the Department of Health and Social Care (DHSC) announced two patients in England who were members of the same family had tested positive for coronavirus and were receiving specialist NHS care, using tried and tested infection control procedures to prevent further spread of the virus. These are the first cases identified in the UK, but a very interesting blog prepared by Public Health England (PHE) explains the NHS is extremely well-prepared and used to managing infections.  PHE is a world leader in developing techniques to aid the public health investigation of infectious disease and the UK is one of the countries outside China to have an assured testing capability for this disease.  It is a complex test which can differentiate this type of coronavirus from any other coronavirus.  

Health Protection Scotland (HPS) have published resources including a comprehensive document on Wuhan novel coronavirus (WN-CoV) Guidance for Primary Care: Management of patients presenting to primary care 

PHE have published a collection of helpful resources including guidance on aspects such as initial investigation of possible cases, self-isolation for patients under going testing, infection prevention and control, guidance for primary care.  This page also contains links to news and announcements  All resources are reviewed and updated regularly.  Also look at the PHE data on Novel coronavirus (2019-nCoV):epidemiology, virology and clinical features 

UK Travel advice

Regarding travel advice, the Foreign and Commonwealth Office (FCO) advise against all travel to Hubei Province due to the ongoing novel coronavirus outbreak and against all but essential travel to the rest of mainland China (not including Hong Kong and Macao).  More details are found here, including a downloadable map. PHE were advising that anyone who had visited Wuhan in the last 14 days, should stay indoors and avoid contact with others where possible, and call NHS 111 informing them of your symptoms and recent travel to the city. Individuals in Northern Ireland, should call their GP

However in a CMO alert sent on 31^st January 2020, (Alert Reference: CEM/CMO/2020/002) it was recommended that all travellers who develop relevant symptoms, however mild, within 14 days of returning from mainland China, should self-isolate at home immediately and call NHS 111.  This document is essential information of all clinical staff encountering patients with respiratory infections arrived from overseas and can be accessed within in the attachments at the bottom of the page here or directly on the image left below.   This page also provides a flowchart for use in the Management of a suspected case of 2019-nCoV acute respiratory disease or access directly on the image below right .  

   

As the situation unfolds, ongoing updates will be available by checking out the resources above but if an individual is planning travel abroad then excellent travel advice is available from fitfortravel  There is also a specific leaflet entitled Novel Coronavirus (Wuhan, China) Infection 

TravelHealthPro from NaTHNaC have advice for Coronavirus (2019-nCoV)  

This current information for travellers advises the following:

To reduce the risk of coronavirus infection all travellers should:

•   Maintain good hand and personal hygiene. Wash hands regularly with soap and water or a disinfectant before handling or consuming food.
• Avoid visiting live bird and animal markets, backyard or commercial poultry farms and do not touch wild or domestic birds (alive or dead).
• Avoid any contact with animals, birds or surfaces that may be contaminated with animal or bird dropping.
• Avoid eating or handling undercooked or raw meat including poultry, egg or duck dishes.
• Avoid close contact with anyone with cold or flu-like symptoms, or who appears unwell.Avoid sharing personal items.

To reduce the risk of passing coronavirus to others, anyone with respiratory symptoms should:

• Cover the nose and mouth when coughing and sneezing with a tissue or flexed elbow
• Use paper tissues only once and dispose of them carefully
• Should a mask be worn, all the recommended precautions in order to minimise the risk of transmission should still be used

There is currently no preventive vaccine or specific treatment for Coronavirus (2019-nCoV). 

Developments on novel coronavirus (2019-nCoV) is clearly an unfolding picture, but the speed with which the world seems to be responding so quickly is positive.    

UPDATE ON NEW RESOURCES 

• The WHO posted a great information video late on 31st January
• On 1st February PHE published a new page 'Guidance to assist professionals in advising the general public'
• On 2nd February the DHSC launched a Coronavirus public information campaign across the UK
• On 3rd February PHE published new information on Novel coronavirus (2019-nCoV): guidance for healthcare providers with staff who have travelled to China
• The CBBC Newsround has published a short video with Dr Chris and Dr Xand - Coronavirus: Why it might not be as scary as it sounds  A great little clip particularly for children.  
• BMJ Coronavirus resources here
• The Lancet 2019-nCoV Resource Centre here 
• BMJ Best Practice COVID-19 here