COVID-19

- 27 March 2020

Dear Green Square Health family.

We know it is an increasingly stressful period of time and uncertainty with all the events currently unfolding.
In order to make safety a priority, Green Square Health is instituting the following guidelines to protect our patients, staff and health care workforce.

We know what can happen in countries that share many similarities with ours, and only have to look at Italy, the USA, France, Germany or Spain to know we have weeks to get our ducks in order.

Tele-health medicine

From Monday the 30th of March, we will be conducting all consultations initially through tele-health.

  • Tele-health consultations will be able to be rebated as usual consults had been in the past (this was not allowed for the last few weeks due to legislation – you will have the medicare rebate returned to your bank account)
  • Health care card holders, disbility pension card holders, and patients under 16 years of age will have their tele-health consultations bulk billed
  • The front door will be closed, and no one will be permitted to enter unless previously triaged and booked by  your doctor following a tele-health consultation

For existing patients, it is best to book in with the doctor you have seen the most regularly or recently, so they can address your immediate health concerns with a good background understanding of your general health.

If there is anything that needs to be visually assessed, your doctor will invite you to a video consult and observe any rashes, lesions, injuries, or be able to assess your general appearance over video. Standard fees apply for face to face consultations.

If they feel they need to see you in person, we will arrange a specific time with you to do this.

Booking for tele-health appointments

Please use the book online button on this website to arrange a tele-health appointment with your doctor of choice.

We do apologise that this call will be in a window period of 30 minutes before, or 60 minutes after your scheduled time. As some calls require a secondary video consultation, and others can be sorted quickly, having a 15 minute appointment for every patient will severely restrict your doctors ability to spend the appropriate amount of time with each patient. If it is an emergency such as chest pain, shortness of breath, signs of stroke – please call 000.

If you think the consult is more urgent, please call the clinic and ask to speak to the nurse, who can prioritise your tele-health consult.

Video consultations

We will be able to assess conditions via video if necessary. To help facilitate this, please install the ZOOM cloud meetings app on your smartphone, or on your computer. Your device will need a camera, hence smartphones are usually best. Your doctor will tell you how to connect if they require video.

Covid-19 testing

We can not test for COVID-19 at GS Health, as we have inadequate supplies of personal protective equipment.

However if after a consultation with your doctor it is deemed that you require a test, we will email you a pathology request form, and direct you to a website where all the local testing centres are, their operating hours and how to attend.

The list can be found at www.cesphn.org.au/coronavirus

NSW Health recommends testing of;

  • travellers with respiratory symptoms or fever within 14 days of return from overseas
  • people who have been in close contact with confirmed COVID-19 cases with respiratory symptoms or fever within 14 days of last contact
  • healthcare workers with recent onset of respiratory symptoms or fever, regardless of travel history. Healthcare workers with fever or respiratory symptoms should be assessed for testing on a case-by-case basis.
  • patients admitted to hospital with acute respiratory illness or unexplained fever
  • patients with acute respiratory illness or fever in high-risk settings, such as hospitals, aged care facilities, residential care facilities, boarding schools and cruise ships
  • patients with acute respiratory illness or fever with reported links to COVID-19 outbreak settings
  • patients with unexplained respiratory symptoms or fever in rural and remote Aboriginal communities.

Government guidelines currently state that people with no symptoms should not be tested (whether we at GSH agree with this or not is a separate issue)

For definitions of close and casual contacts, please visit https://www.health.nsw.gov.au/Infectious/diseases/Pages/2019-ncov-case-definition.aspx#close-contact

Pathology and bloods

Routine pathology and follow up blood tests for preventative medicine will be postponed.

Due to shortages of PPE (personal protective equipment) pathology providers have had to consolidate their collection centres, and as such from Monday the 30th pathology collection will not be available at GSH.

The closest sites are at Broadway and Botany.

However if your doctor reports you need a blood test or other pathology test, they will still be able to provide you with a pathology form to your email address.

Closest collection centres:

Laverty

Broadway

(02) 9282 9245
Shop M109 Broadway
Healthcare floor
Broadway shopping centre, NSW 2007
Mon-Fri 8am – 7pm
Sat 9am-1pm

Botany

(02) 9700 0498
1419 Botany Rd
Botany, NSW 2019
Mon-Fri 8am-5pm
Sat 8am-1pm

Important preventative healthcare

We understand that other conditions and diseases will not stop and pause for COVID-19, and it is important that we provide screening and checks for these conditions, as well as immunisations that are upcoming. However these will only be booked in after a telephone consultation with your doctor first.

Cervical screening

If you are due for cervical screening, please call to make an appointment. We will run a fortnightly clinic just for cervical screening. Your doctor can book you in after you’ve had a phone consult to ascertain if this can be reasonably delayed, or should be done soon.

If you have any respiratory symptoms, have travelled from overseas in the last 14 days, have a confirmed contact of COVID-19, or have any unwell contacts at home, we ask that you delay doing your cervical screening until you are clear of the above, and 72 hours symptom free if applicable.

Skin cancer checks

If you have a history of melanoma, SCC or BCC and are coming for a repeat yearly check up, we will offer these clinics fortnightly. This will only be booked in by your doctor after you have had a telephone consultation, then a video consultation (likely at the same time) to ascertain the risk level. Dr Holly Inglis and Dr Daniel Chanisheff will be offering this service. Whilst it is not a replacement for an in person skin check, during this time this appears to be a safe balance.

So if you have a lesion that you are worried about and don’t have a personal history of skin cancer, please book online for a telehealth appointment and let the doctor know so they can arrange an initial video consultation.

If you have any respiratory symptoms, have travelled from overseas in the last 14 days, have a confirmed contact of COVID-19, or have any unwell contacts at home, we ask that you delay doing your cervical screening until you are clear of the above, and 72 hours symptom free if applicable.

Childhood immunisations

For routine childhood immunisations that are due, the clinic will contact you to make a plan. If we have not contacted you, please book with your regular doctor for a telephone consultation first, and we can arrange a time for you to come in.

These will be done on a set day once a fortnight, with full PPE and hospital level cleaning between patients. This visit will only be for immunisations and basic age appropriate examination.

Detailed developmental assessment can be arranged over the phone with your doctor at a different time. We may be doing immunisations in a 2 week window following your child due date to arrange the safest way to do this for your family.

If you have any respiratory symptoms, have travelled from overseas in the last 14 days, have a confirmed contact of COVID-19, or have any unwell contacts at home, we ask that you delay doing your cervical screening until you are clear of the above, and 72 hours symptom free if applicable.

Unwell children

It is difficult to rely on history alone for children 5 and under, so we will attempt to arrange any telehealth consultations via video. If we are concerned we will ask you to come in, and prepare a room where your doctor is in full protective equipment (stocks allowing). As our doctors have stated, ‘we’d rather get potentially exposed than not examine a sick child’. 

If you have booked a telephone consultation but feel  your child may need to be assessed more urgently, please call the clinic and ask to speak to the nurse in regards to this. They can take a history and move you up the queue with your doctor if necessary.

If you think your child very unwell, please call 000 or attend emergency, but if it isn’t that urgent, we will likely plan your visit at the end of the day so the room can be thoroughly sterilised after use.

Pregnancy care

Pregnancy consults are best done face to face, but most questions can be first answered over the phone. In order to ensure our pregnant patients are safe, we will group our pregnancy care appointments together and roster staff to sterilise room and equipment between each use. So please make a tele-health appointment with your doctor who provides you with shared care, and they will book you to come in person.

We will also be performing influenza and whooping cough vaccines on our pregnant patients, but can not offer whooping cough vaccinations to family members. The evidence for this is maternal transfer of antibodies provides adequate protection for newborns until they have their first immunisation, and with good social distancing there is no need for family members and friends to come into medical facilities to get vaccinated. Pregnant patients getting their vaccine is the best protection.

Influenza immunisations

The 2020 influenza immunisation program will be more important than ever this year.

The government funded vaccines will be available in mid April, and the following population groups are eligible.

  • all Aboriginal and Torres Strait Islander people aged 6 months and over
  • all children aged 6 months to less than 5 years of age (including Aboriginal and medically at risk)
  • all individuals aged 5 years and over with medical risk conditions, namely:
    • cardiac disease, including cyanotic congenital heart disease, coronary artery disease and congestive heart failure
    • chronic respiratory conditions, including suppurative lung disease, chronic obstructive pulmonary disease and severe asthma
    • other chronic illnesses requiring regular medical follow up or hospitalisation in the previous year, including diabetes mellitus, chronic metabolic diseases, chronic renal failure, and haemoglobinopathies
    • chronic neurological conditions that impact on respiratory function, including multiple sclerosis, spinal cord injuries, and seizure disorders
    • impaired immunity, including HIV, malignancy and chronic steroid use
    • children aged 6 months to 10 years on long term aspirin therapy
  • pregnant women (influenza vaccine can be given at any stage of pregnancy)
  • people aged 65 years and over (vaccine that is specifically designed to produce a higher immune response is available for this group).

If you do not fall into this category, an influenza vaccine will still be available, but must be purchased privately. 

The vaccination is $25, and when available we will hold vaccination clinic times.

We thank  you again for your patience and understanding.
Our decision process hasn’t been easy, but we all decided to put safety as our number 1 priority for our patients, community and staff.

Dr Daniel Chanisheff

May 23

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