Last reviewed 17 April 2020
The National Institute for Health and Care Excellence (NICE) has published more "rapid guidance" documents on maximising the safety of patients during the COVID-19 pandemic with chronic obstructive pulmonary disease (COPD), cystic fibrosis, and dermatological conditions treated with drugs affecting the immune response.
The new guideline is for health and care practitioners; health and care staff involved in planning and delivering services; and commissioners.
As part of a range of "rapid guidance" in response to the COVID-19 outbreak, including on managing symptoms of COVID-19 in the community and advice on management of patients at risk of complications from the virus, the following guidelines that are useful for GPs and their teams have been issued:
"COVID-19 Rapid Guideline: Community-based Care of People with COPD" at: https://www.nice.org.uk/guidance/ng168
"COVID-19 Rapid Guideline: Cystic Fibrosis" at: https://www.nice.org.uk/guidance/ng170
"COVID-19 Rapid Guideline: Dermatological Conditions Treated with Drugs Affecting the Immune Response" at: https://www.nice.org.uk/guidance/ng169
Patients with these diseases are at increased risk of severe illness from COVID‑19. The guidelines say this needs to be communicated with patients, their families and carers, together with an offer of support for their mental health and wellbeing to help alleviate any anxiety and fear they may have about COVID‑19.
The guidelines suggest GPs can signpost people with COPD to charities such as the British Lung Foundation, together with support groups such as NHS Volunteer Responders, and UK government guidance on the mental health and wellbeing aspects of COVID-19, at: https://www.gov.uk/government/publications/covid-19-guidance-for-the-public-on-mental-health-and-wellbeing/guidance-for-the-public-on-the-mental-health-and-wellbeing-aspects-of-coronavirus-covid-19
Some patients with severe conditions will have received a letter telling them they are at very high risk of severe illness from COVID‑19. They, or their families and carers, should be asked to follow UK government advice on shielding and protecting people defined on medical grounds as extremely vulnerable from COVID-19, available at: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
The guidelines advise GPs on how to minimise face-to-face contact with these patients, how to manage those not known to have COVID-19, and the treatment and care planning for those who are known or suspected to have COVID-19.
Similar advice is given for communications with patients with cystic fibrosis and dermatological conditions treated with drugs affecting the immune response, signposting them to charities such as the Cystic Fibrosis Trust and online sources of information such as the British Association of Dermatologists’ patient hub, and providing advice on treatment considerations and modifications required to usual care and service delivery.
The Royal College of General Practitioners (RCGP) has also produced a guide and learning resources for community palliative, end-of-life and bereavement care during the pandemic at: https://elearning.rcgp.org.uk/mod/page/view.php?id=10537
NICE developed the “rapid” recommendations in direct response to the rapidly evolving COVID-19 pandemic, and could not therefore follow the standard process for guidance development.