Coronavirus (COVID-19): fertility treatment - plans for restarting treatment - framework

In response to the direct threat of COVID-19 to patients, the wider Scottish population and NHS Scotland services, all NHS funded Scottish centres took the decision to pause services from 17 March 2020. This document sets out the plans for restarting fertility services from 18 May 2020.

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5 Support

5.1 Support for patients

Counsellors are an integral part of the treatment and support offered by the clinics as per regulatory requirements. Counselling will be offered remotely using telephone appointments or systems e.g. attend anywhere, near me, which will significantly reduce the number of face-to -face appointments, hospital attendances and staff-patient contact time. Information about counselling will be made available on webpages of all clinics.

There is work being undertaken to develop online/video psychosocial educational groups as well as possible support groups. As a result of welfare of the child considerations or case complexity, on occasion face to face counselling or assessment may still be required in the medium term.

We plan to host Webinars for patients instead of face to face patient information evenings (PIE) that are usually attended by multiple patients together, to keep the interaction and be able to answer the queries. We also aspire to do sessions for patients for specific causes of infertility e.g. male factor, endometriosis etc. using online platform, jointly across Scotland. This will not only maximise the use of resources but will help in providing consistent information to patients across Scotland.

All clinics will ensure support for patients by increasing the capacity to answer queries via telephone and emails. In addition to sharing the good practices, clinics will share any online resources so that there is no duplication of efforts e.g. no delays by NHSG.

As part of information during the treatment patients will be advised that other services in NHS e.g. Early Pregnancy Assessment Units may have different policies during COVID-19.

Patients have already been advised through communication put on the website that clinics are not open yet but can apply to open in the week beginning 11th May. Clinics will be in touch with patients on the waiting lists as soon as they can proceed with treatments safely. Prior to any treatment patients will be provided with information relating to the risk of Covid-19 by coming to hospital, in pregnancy and be offered the choice to defer treatment by signing the consent form (Appendix 1).

Fertility Network is the leading patient-focused fertility charity and provides free and impartial support as well as advice at practical and emotional level to improve information and understanding. Patients have access to a support line manned by a retired fertility nurse and a community of people affected by fertility problems at https://fertilitynetworkuk.org/ or

Scotland Coordinator: 07411 752688 or Support line: 0121 323 5025

Patients can also access more information from following webpages

5.2 Support for Staff

As there will be a number of significant changes in the ways of working, clinic leads will ensure communication within their own multi-disciplinary teams. This is especially important as many staff have been redeployed. They will need to be recalled, when safe and feasible to do so. There will be a period of retraining, mock drills and refining the process to ensure that new ways of working are feasible and are abiding by the principles outlined in section 2. Good practices will be shared across all clinics in regular weekly meetings. Staff support policies and procedures will be in place in each clinic to ensure that:

- The mental well-being of staff is considered and reviewed as necessary

- Staff support and counselling systems are in place should they be needed

- Staff continue to be engaged and encouraged to provide feedback on progress and potential improvements to treatments during the COVID-19 pandemic

- Peer support is available as needed

- Staff safety in the workplace is paramount and centres should ensure that risk assessments are in place where appropriate to minimise the risk of infection

There are individual health board web pages e.g.

https://covid19.nhsgrampian.org/for-nhs-grampian-staff/ http://intranet.lothian.scot.nhs.uk/StaffRoom/StaffHealthAndWellbeing/Pages/default.aspx

https://www.nhsggc.org.uk/your-health/health-issues/covid-19-coronavirus/

There was also support amongst group to share the staff continuous professional development (CPD) sessions as they will now all be done remotely. This will not only enhance communication but will reduce the variability of practices across Scotland.

5.3 Code of conduct for Staff

All staff members will be asked to read and sign a code of conduct when clinics reopen, as required by HFEA (Covid -19 Self-assessment questions 11,12,13) as a prerequisite to grant permission to provide licenced treatments. This will instruct to avoid unnecessary exposure (both at work and in private) as per current government policies for social distancing. This will be emphasised in team briefs. Attendance at work will be tied to respecting this Code of Conduct. Staff members will inform their line manager of any infringements of the Code of Conduct previously signed.

If triage questionnaire (e.g. in Appendix 2) is completed, answering Yes to any question in the questionnaire, staff may be advised isolation/testing as per local policy advised by Public Health Scotland. In addition to following Government guidance, Staff who are shielding or who live with someone who is shielding, will not be involved in care of patients.

5.4 Code of conduct for Patients

All patients will be instructed to sign a consent prior to commencing any treatment, which will incorporate the code of conduct to avoid unnecessary exposure (both at work and in private) as per current government policies for social distancing. The triage questionnaire (Appendix 2) will be filled in 2 weeks prior to commencing treatment and will be confirmed at each interaction.

Contact

Email: anthea.taylor@gov.scot

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