Llantwit Major & Coastal Vale Medical Practice

Joint Injections (Steroid) – during Covid19

Please read the information provided fully before completing any of our online forms

Steroid (cortisone) injections were stopped nationally at the start of Covid-19 pandemic due to concerns that there was a risk affecting your immune system making you more likely to contract Covid-19 and if you do catch Coronavirus you are more likely to be seriously affected. The ongoing pandemic means that to keep patients safe we are trying is to minimise footfall to the surgery and therefore seeing patients at surgery only when it is essential to do so. The requirements for social distancing, PPE and necessary cleaning between patients makes appointments longer and our priority is to keep patients safe whilst demand for our services is increasing again.  

Steroid injecting, as with minor surgery and some other services, is categorised as an enhanced service, not a core service. This means that it is not in the GP contract, but an additional service to ease hospital pressures. As such, we are required to prioritise essential core services first as we enter a recovery phase. We still have to consider the risk/benefit of providing injections whilst Covid remains in the community too as the exact risk remains uncertain.

Cardiff & Vale University Health Board has now performed a detailed literature and evidence review and issued strict guidance for risk assessing patients for steroid injecting across GP’s and hospitals within the trust, and enhanced consent documents to which we must adhere to if considering joint injection.

How Will My Risk Be Calculated?

RISK FACTORS IDENTIFIED (CDC)

  • ASTHMA – MODERATE TO SEVERE ONLY
  • CHRONIC LUNG DISEASE – COPD, PULMONARY FIBROSIS, CYSTIC FIBROSIS
  • DIABETES
  • SERIOUS HEART CONDITIONS – HEART FAILURE, CORONARY ARTERY DISEASE, CONGENITAL HEART DISEASE, CARDIOMYOPATHY
  • CHRONIC KIDNEY DISEASE – DIALYSIS
  • SEVERE OBESITY – BMI>40
  • AGE >65 YEARS
  • IMMUNOCOMPROMISED – CANCER TREATMENT, TRANSPLANT INCLUDING BONE MARROW,IMMUNE DEFICIENCY, HIV WITH LOW C4, MEDICATION CAUSING IMMUNOSUPPRESSION INCLUDING LONG TERM STEROIDS
  • LIVER DISEASE – CIRRHOSIS

Patients with multiple risk factors still cannot yet be offered an injection.

*IMPORTANT NOTE* IF YOU DO FALL INTO THE HIGH RISK OR VERY HIGH RISK GROUPS IT WILL BE VERY UNLIKELY YOU WILL BE OFFERED AN APPOINTMENT AS PER THE GUIDANCE ISSUED BY THE LOCAL HEALTH BOARD.

We are constantly reviewing services and how to provide them. If safe, we may look at doing batches pre-planned at some point to help the backlog as we appreciate the significant quality of life impact. To allow us to do this, we are asking for some brief details for those wishing to be considered for an injection, and, volume permitting, we will try and plan a way forward. Once complete, we will assess the forms and, when we are able to start again, contact patients to invite them to arrange an appointment, but please allow us time to manage the likely large demand.

PLEASE BE AWARE IF YOU WISH TO HAVE MORE THAN ONE JOINT INJECTED WE CAN ONLY DO ONE JOINT PER APPOINTMENT AND THERE HAS TO BE A 6 WEEK GAP BETWEEN INJECTIONS. THIS IS FOR YOUR SAFETY AND TO MINIMISE YOUR RISK WITH REGARD TO COVID19

Please fully complete both parts of the request – PART 1 (depending on which joint you are requesting injection) and PART 2 the Consent form. 

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