NHS Dumfries & Galloway

Renewal of non-COVID services

In line with other Board areas, work has been underway on the renewal of non-COVID services. However, this is enormously complicated and it will be a slow journey to renew services step by step, making sure that we balance the risk of COVID infection against the benefit of re-introducing that service.

We are mindful that, every step of the way, we may need to retract services again if we see a second wave of COVID with a significant increase in infections in the community.

In this following section you will find information on changes to non-COVID services, and this is being updated constantly as these changes take effect…

Latest developments

  • 19 August - CHILDREN AND NEONATAL SERVICES
  • 17 August – DENTAL
  • 14 August - SURGERIES
  • 10 August - SHORT BREAK SERVICES
  • 20 July - COMMUNITY AHP SERVICES
  • 13 July - VISITING

Children’s services have continued to provide emergency and urgent cover throughout the pandemic. NHS Near Me consultations have continued to take place for some routine cases. We are now welcoming children back into the outpatient clinics following appropriate physical distancing and infection control measures. Face-to-face appointments have resumed at Dumfries and Galloway Royal Infirmary and are due to resume shortly in clinics including The Willows in Dumfries and Stranraer.

As of August 17, the majority of General Dental Practices will be able to see up to five patients requiring aerosol generating procedures each day if appropriate risk assessments are completed and aerosol personal protective equipment (PPE) is worn. Urgent care requiring the use of aerosol generating procedures also continues to be able to be provided by dentists for their own patients and by public dental service staff for unregistered patients at the established Urgent Dental Care Centres in the region.

Hip and knee elective surgeries are resuming within Dumfries and Galloway next week, but surgeries for orthopaedic trauma have continued throughout the pandemic. Guidance is provided to patients in advance. In line with current standard practice for all Scottish Boards, patients are asked to self-isolate for two weeks prior to admission, are tested prior to admission and assessed on the day.

Short Break Services are anticipated to resume in Dumfries and Galloway in the week commencing August 24. However. it will not be possible to provide the pre-COVID -19 level of service due to staffing limitations and issues re physical distancing. If there is any change to the identified risk which means it cannot be delivered safely, such as a further wave of coronavirus, then any service may once again be suspended in response to those dangers. Dumfries and Galloway Health and Social Care Partnership hopes that Action for Children will be able to recommence their work looking at the long-term shape of short break services for children in September.

AHP is the umbrella term covering a host of therapy services such as Dietetics, Physiotherapy, Podiatry, Occupational Therapy, Speech and Language Therapy. Community AHP services are now taking safe steps to increase treatments across the region and address waiting lists and new referrals. Initially you may be offered a telephone or video appointment; however, face-to-face contacts will continue to be carried out as part of AHP interventions where appropriate. When attending your appointment you will be asked some COVID-related screening questions and may have to wear a face mask. This information will constantly be under review and clarification will be given with your appointment letter.

Very limited patient visiting resumes in hospitals within Dumfries and Galloway from today. In order to protect patients, visitors, staff and communities from the dangers of COVID-19, many restrictions apply for those people who will be visiting a hospital inpatient This includes each patient having only one named visitor for the duration of their stay in hospital, restrictions on access to specific patient areas, a need for visitors to wear face coverings and follow hygiene guidance. Visitors will need to agree in advance with the ward/hospital when they are coming and we ask that they only stay for a short period. For more information, visit https://www.nhsdg.co.uk/limited-hospital-visiting-resumes/

In these following sections you will find an archive of changes which have already been introduced, broken up into different areas of service

Information by area

20 August – GENERAL PRACTICE: General Practices across Dumfries and Galloway continue to offer urgent and routine care to patients. Practices are operating within the limitations of physical distancing and infection control arrangements. Practices continue to offer triaging, telephone appointments and face-to-face appointments with a full range of services. Any changes in provision of general medical services will be influenced by any increase in  COVID-19 activity to enable practices to cope.

17 August – DENTAL: As of August 17, the majority of General Dental Practices will be able to see up to five patients requiring aerosol generating procedures each day if appropriate risk assessments are completed and aerosol personal protective equipment (PPE) is worn. Urgent care requiring the use of aerosol generating procedures also continues to be able to be provided by dentists for their own patients and by public dental service staff for unregistered patients at the established Urgent Dental Care Centres in the region.

3 August – OPTOMETRY: Routine eye care has resumed within optometry practices and in patients’ own homes with effect from August 3 2020.  In resuming the provision of routine eye care services, practitioners are prioritising those patients who are considered to be most at risk in the professional judgement of the optometrist or ophthalmic medical practitioner. Emergency and essential care is prioritised over more routine services, and will be reflected in the scheduling of appointments – with those patients at greatest risk of detriment to sight or wellbeing being seen first.

20 July – DENTAL: General Anaesthetic sessions via the Public Dental Service restart at the Dumfries Dental Centre on July 30 and at the Stranraer centre at Galloway Community Hospital in mid August for patients who have been waiting since before COVID. Public Dental Service practitioners are reviewing their special care patients to prioritise stabilising patients, scheduling patients for non-aerosol generating procedures and seeking to bring open courses of treatment to a close. Routine special care clinics have recommenced at both DDC and GCH clinics, including use of sedation. Urgent patients are being prioritised as before plus also now patients waiting on SCP assessment – medically compromised, learning and physical disability and patients with mental health problems. Weekly DGRI dental theatre and monthly GCH dental theatre sessions have both resumed, with the prioritisation of patients in line with criteria.

29 June – OPTOMETRY: Optometry practices are able to see patients face-to-face for emergency and essential eye care from today, Monday June 29, as part of Phase 2 of the Scottish Government’s recovery route map. To ensure the safety of patients and staff, all practices have Personal Protective Equipment (PPE), and have put in place arrangements to comply with physical distancing and enhancing their infection control processes.

22 June – DENTAL: A limited range of treatment for urgent and emergency cases is being offered at dental practices within Dumfries and Galloway from today. Dental practices still cannot perform aerosol-generating procedures such as drilling teeth, which greatly limits the services they can offer. Anyone requiring emergency treatment which requires an aerosol-generating procedure will still be able to receive this treatment at a dedicated facility within the region. Anyone requiring emergency treatment should contact their dentist by phone in the first instance.

27 August – CARDIOLOGY: During the pandemic the majority of routine OP clinics have been carried out via telephone. All return patients are being seen virtually.

27 August – DIABETES: Treatment plans have been sent to routine patients during COVID-19. Face-to-face patients are now being seen as of 29 July. However, the majority of patients are being seen via NHS Near Me.

27 August – GASTROENTEROLOGY: Routine had been carried out virtually since March, but routines are now being carried out face-to-face as of the beginning of July.

27 August – GENERAL MEDICINE: All routine elective appointments are being carried out via NHS Near Me or telephone unless face-to-face appointments are required.

27 AUGUST RESPIRATORY AND RHEUMATOLOGY: Routine outpatient activity has been carried out virtually and face-to-face.

27 August – NEPHROLOGY: Urgent patients have been sent to Glasgow during COVID. Routine outpatients started on August 5, with clinics occurring every two weeks. Treatment time guarantee scheduling began on August 19.

27 August – ANAESTHETICS: Routine outpatient activity has taken place virtually, but with face to face appointments due to begin on September 1.

27 August – GYNAECOLOGY: Urgent outpatients have been able to be accommodated, with routine patients being seen as per availability.  

27 August – OPTHALMOLOGY: Routine Macular outpatient appointments have been taking place due to a degenerating condition if left unattended. Routine treatment time guarantee cataract procedure began on July 13. No other routine elective procedures are taking place.

27 August – PAIN: Education Classes being done virtually.

27 August – ORTHODONTICS: Patients on treatment are currently being prioritised, with an anticipated restart date of October 20

27 August – UROLOGY: urgent patients ave been prioritised.

14 August – ELECTIVE SURGERIES: Hip and knee elective surgeries are resuming within Dumfries and Galloway next week, but surgeries for orthopaedic trauma have continued throughout the pandemic. Guidance is provided to patients in advance. In line with current standard practice for all Scottish Boards, patients are asked to self-isolate for two weeks prior to admission, are tested prior to admission and assessed on the day.

14 August – GALLOWAY COMMUNITY HOSPITAL: A phased return for outpatients means that, as of August 17, outpatient clinics for acute services will be running at 75% – including the new phlebotomy clinic. This is on schedule to return to pre-COVID levels of 100 per cent by September 2020. Day theatres have started scoping and dentals from August 10. Radiology have been back to pre-COVID service since mid July 2020.  

23 July – DERMATOLOGY, ONCOLOGY AND HAEMATOLOGY: All three outpatient services have continued throughout the pandemic. During the pandemic, some Oncology and Haematology patients were identified to take shielding precautions. Patients were supplied with guidance regarding the shielding process and Local Authorities offered assistance for extra support.  Shielding has now been paused but new patients will continue to be registered so that contact can be made at an early stage should shielding be restarted.   

23 July – PHYSIOTHERAPY: Physiotherapy services should now be looking at returning patients, including routine appointment, from the beginning of August. This includes routine/backlog patients who require face-to-face interventions following Active Clinical Referral Triage and, where appropriate, telehealth interventions have preceded but not addressed the patient’s concerns. This is in line with out-patients, ie consultant at DGRI, returning to routine appointments from the beginning of August. Physical distancing measures and risk reducing measures are in place to help prevent cross infection of COVID-19 and containing potential spread.

13 July – CHEMOTHERAPY CLINIC: Since the beginning of the pandemic, the Chemotherapy Clinic has continued to safely deliver systemic anti-cancer treatments. Face-to-face Oncology Out-Patient appointments were only offered where there was a clinical requirement for patients to attend and patients were either contacted by telephone or via the NHS Near Me video consultation platform. Face-to-face routine appointments have now started to resume, with ongoing COVID assessments.

13 July – MACMILLAN CANCER INFORMATION AND SUPPORT: Due to the current COVID-19 situation, the Macmillan Cancer Information and Support Centre in Dumfries and Galloway Royal Infirmary and the Stranraer Cancer Drop in Centre had not been able to offer their ‘drop in’ or face-to-face services and were utilising other ways to offer support. However both centres are now able to see a patient or their family member face-to-face, on a planned appointment basis only. The centres will continue to offer video call support via the ‘NHS Near Me’ platform as well as telephone and/or email contact as required for patients and their families. Relevant written information booklets for service users can be posted out to anyone who needs them. For enquires about appointments at the Dumfries Macmillan Cancer Information and Support Centre, please contact Centre Manager Claire Drummond on 01387 241979 Monday to Friday 10.00am to 4.00pm or by email: claire.drummond@nhs.net For any enquiries about appointments at the Stranraer Cancer Drop in Centre, please contact Centre Manager Aileen McClymont on 01776 707778, Wednesdays to Fridays, 10.00am to 3.00pm, or by email to aileen.mcclymont@nhs.net

13 June – VISITING: Very limited patient visiting resumes in hospitals within Dumfries and Galloway from today. In order to protect patients, visitors, staff and communities from the dangers of COVID-19, many restrictions apply for those people who will be visiting a hospital inpatient This includes each patient having only one named visitor for the duration of their stay in hospital, restrictions on access to specific patient areas, a need for visitors to wear face coverings and follow hygiene guidance. Visitors will need to agree in advance with the ward/hospital when they are coming and we ask that they only stay for a short period. For more information, visit https://www.nhsdg.co.uk/limited-hospital-visiting-resumes/

31 July – PSYCHOLOGY: Clinicians are currently working to address those waiting the longest on the routine waiting list. New referrals for screening to join the list for group or 1:1 work is scheduled to recommence in September 2020. 

31 July – PSYCHOLOGY WELLBEING HUBAll new referrals and contacts are being directed to fast access psychological services – self referral and primary care referral for COVID-19 related concerns or psychological first aid.

31 July – PRISON HEALTHCARE: Prison health care are providing routine contact. There has been a reduction in the ability to refer to secondary services, and the GP contracted service has been primarily employing NHS Near Me consultation. Prison Health care can be limited due to Scottish Prison Service Operational decisions, such as prison opening times.

31 July – MIDPARK HOSPITALMidpark Hospital is fully operational, with all six wards areas providing specialist inpatient mental health care and treatment. The Mental Health Acute Liaison service are now providing a 7 day service and are accepting urgent and emergency referrals. Electro-convulsive services are being provided on an Emergency and Urgent basis. Planned admissions from Specialist Drug and Alcohol Service for detoxification remain suspended, although this is currently under review. 

31 July – INTELLECTUAL DISABILITY SERVICEAll new referrals and ongoing case work has continued to be seen by the nursing team. Health Facilitators have recommenced health checks. Building Based Day Care (ARC) is currently restricted to two individuals based on critical need. Care at home and online support is being offered as an alternative to building based support. Housing Support services have continued to provide support. Plans are in place for the respite service to be remobilised by the end of September 2020. 

31 July – SPECIALIST COMMUNITY MENTAL HEALTH TEAMS (CMHTs) AND CRISIS ASSESSMENT AND TREATMENT SERVICE (CATS): All emergency referrals are now being triaged by the East/West CMHTs teams. Intensive Home Based Treatment for individuals continues.All other referrals, whether routine or urgent, are being triaged, prioritised and responded to appropriately to individual’s needs. Routine work within the CMHT continues, including joint assessment clinics and joint review clinics. Face-to-face Specialist Eating Disorder Service support has been reintroduced in July. The primary care dementia pathway is set to restart in August 2020.

31 July – SPECIALIST DRUG AND ALCOHOL SERVICE: This service has remained open during the COVID period to receive referrals, although there has been reduced face-to-face consultations due to physical distancing arrangements. Inpatient alcohol detoxification is currently unavailable. This position is being kept under regular review.

31 July – MENTAL HEALTH SERVICESAll Mental Health Services have changed to ensure ongoing compliance with physical distancing requirements. Remote contact via NHS Near Me or by telephone will be offered for appointments if appropriate and possible. All staff will be wearing PPE if an in-person face-to-face consultation is required. If there is any change to the identified risk which means services cannot be delivered safely, such as a further wave of coronavirus, then any service may be suspended in response to those dangers.

13 July – MIDPARK HOSPITAL: Phase 2 of hospital visiting has been implemented across all inpatient ward areas in line with Scottish Government Guidance. This was introduced today to include visits from one designated visitor. Necessary infection control measures have also been introduced within clinical areas to support these visiting arrangement

August 26 – Sexual Health DG – Counselling for vasectomy under local anaesthetic recommenced within Sexual Health. Patients can self refer by phoning 0345 702 3687 Mon – Fri 9.00am-4.00pm or by emailing dgsexualhealth@nhs.net

Sexual Health D&G remain open, offering telephone or video consultations (called ‘NearMe’) for any sexual health queries or concerns. 

Appointments can be booked online (https://sexualhealthdg.co.uk/clinics.php#book) or by phoning 0345 702 3687 Monday – Friday 9am – 4pm.

The clinician may be able to offer a solution without having to see you face to face as prescriptions and tests can be posted or medication collected. The clinician can offer a face to face appointment if necessary and will arrange this with you.  There are measures in place within our clinics to ensure the safety of patients and staff.

August 19 – CHILDREN AND NEONATAL SERVICES: Children’s services have continued to provide emergency and urgent cover throughout the pandemic. NHS Near Me consultations have continued to take place for some routine cases. We are now welcoming children back into the outpatient clinics following appropriate physical distancing and infection control measures. Face-to-face appointments have resumed at Dumfries and Galloway Royal Infirmary and are due to resume shortly in clinics including The Willows in Dumfries and Stranraer.

August19 – GENITAL WARTS: patients with genital warts can now receive cryotherapy treatment for their warts.

August 10 – SHORT BREAK SERVICES: Short Break Services are anticipated to resume in Dumfries and Galloway in the week commencing August 24. However. it will not be possible to provide the pre-COVID -19 level of service due to staffing limitations and issues re physical distancing. If there is any change to the identified risk which means it cannot be delivered safely, such as a further wave of coronavirus, then any service may once again be suspended in response to those dangers. Dumfries and Galloway Health and Social Care Partnership hopes that Action for Children will be able to recommence their work looking at the long-term shape of short break services for children in September.

July 31 – MATERNITY SERVICE: Maternity service has been provided throughout the pandemic period and patients have been using NHS Near Me virtual consultations. This has saved on journeys and potential exposure to COVID but will be reviewed to assess patient satisfaction levels and whether it should continue. A move now allows one other person to be present during scan appointments.

JULY 31 – ASYMPTOMATIC CHLAMYDIA/GONORRHOEA TESTING: This service is operating, and people wishing testing who have no symptoms are encouraged to contact Sexual Health for a risk assessment. Those under 25 and with other risk factors will be prioritised.

July 31 – HIV TESTING: This service is running, and people are encouraged to contact Sexual Health and to access HIV testing if there is any sexual or drug use risk   

31 July – PHYSIO MUSCULOSKELETAL: Face-to-face community muskuloskeletal services based at Mountainhall Treatment Centre resumed on 17 August. Face-to-face services at Galloway Community Hospital are due to start on 7 September, with plans for services in Annan to follow. All first appointments are by telephone.

31 July –  ORTHOTICS: Adults and children are being seen for fittings as required. Others are being seen via NHS Near Me and/or via telephone. No clinics are running at Galloway Community Hospital as yet.

31 July –  PULMONARY REHAB: Pulmonary rehab classes are currently being performed either virtually or by phone call. Some visits in people’s homes are taking place. Outpatient appointments are via NHS Near Me or telephone.

31 July – WOMEN’S HEALTH: Women’s health services commenced face-to-face appointments in the week of August 10, taking place at Dumfries and Galloway Royal Infirmary only. Telephone and NHS Near Me consultations also continue where appropriate.

31 July –  CHRONIC PAIN AND CARDIAC REHABILITATION: Both these services are currently being delivered either by telephone or virtually.

31 July –  OCCUPATIONAL THERAPY MUSCULOSKELETALTrauma, post trauma and some post surgery services are being seen in the orthopaedic outpatient department in Dumfries and Galloway Royal Infirmary. Routine appointments are being seen face-to-face if required at Mountainhall Treatment Centre starting from August 17. All first appointments by telephone

31 July – PHARMACY: GP practice-based pharmacy staff have maintained a presence in practices throughout the pandemic response. They have been able to continue to serve as an expert source of advice for people in managing their medicines safely and effectively and also in dealing with the management of acute and chronic conditions within each practitioner’s competence. Face-to-face consultations are not yet taking place again due to physical distancing and in line with how GP practices are operating. Telephone consultations are the main method of engaging with individuals.  

20 July – COMMUNITY AHP SERVICES: AHP is the umbrella term covering a host of therapy services such as Dietetics, Physiotherapy, Podiatry, Occupational Therapy, Speech and Language Therapy. Community AHP services are now taking safe steps to increase treatments across the region and address waiting lists and new referrals. Initially you may be offered a telephone or video appointment; however, face-to-face contacts will continue to be carried out as part of AHP interventions where appropriate. When attending your appointment you will be asked some COVID-related screening questions and may have to wear a face mask. This information will constantly be under review and clarification will be given with your appointment letter.

30 June – ADULT CARE SOCIAL WORK: In line with statutory duties and responsibilities, Adult Care Social Work continue to offer the full range of services. People can continue to access services via the contact centre or via the out of hours emergency support line. To ensure the safety of clients and staff, all staff have access to Personal Protective Equipment (PPE) and have put in place arrangements to comply with physical distancing.

20 June – COTTAGE HOSPITALS: Four Cottage Hospitals in Dumfries and Galloway Health and Social Care Partnership have been temporarily dedicated for use as step-down treatment facilities for COVID-19 patients. This is in response to the pandemic, and to ensure sufficient capacity to treat COVID patients. Representing one cottage hospital in each of the region’s four localities, the facilities are Moffat Cottage Hospital, Kirkcudbright Cottage Hospital, Thornhill Cottage Hospital and Newton Stewart Cottage Hospital. Meanwhile, Annan Cottage Hospital has been restricted to an eight bed capacity so as to ensure clinically safe care and reduced risk of transmission.