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Updated shielding Guidelines

Wales

The Chief Medical Officer for Wales has said that shielding should continue until the 16 August 2020. If you are shielding you should have received a letter to tell you this and what to do next. The Chief Medical Officer for Wales will write again to you advising what to do after 16 August 2020. If you haven’t had a letter and think you should have done, then discuss this with your GP.

Shielding is for your protection. It is strongly advised that you to follow this guidance but it is your decision to make. This will be a deeply personal decision and if you are unsure then speak with your family and friends about this, and with your healthcare professionals, if necessary.

Who should be shielding?

Only people (both children and adults) with the most serious underlying health conditions are being advised to shield themselves. For people living with a brain tumour this will be people who are undergoing radiotherapy and/or chemotherapy.

If I am shielding, what can I do?

If you have been shielding at home you can now leave home to exercise or meet outside with people from another household.

You should strictly follow physical distancing (2 metres or 3 steps away from another person) and you should practice good hygiene using a hand sanitiser and avoiding touching things touched by others.

You should stay close to home so you do not have to use a toilet that is not your own and you should not go anywhere indoors other than your own home.

Physical distancing within the home should continue where possible.

The advice has changed because:

1) The number of people who have Coronavirus in Wales has gone down and so the risk of you catching the virus has reduced.

2) We have learned more about how Coronavirus behaves. We know the virus does not spread as easily outside as it does indoors

3) Staying at home for long periods of time can affect your health and well-being.

Northern Ireland

The COVID-19 virus still poses a high risk if someone who is shielding is exposed to it.  However, infection levels in the community are now falling so the risk of exposure is significantly less than it has been.  As this risk is lower, the Chief Medical Officer for Northern Ireland has updated the guidance if you are shielding.

From 6 July, and if the risk continues to be low, people who are following the shielding advice are able to meet up to six people outside of their home, as long as social distancing is strictly observed.

If you are shielding alone, from 6 July you can also form a support bubble with one other household.  Where you form a bubble:

  • social distancing is not required with the other household in your bubble; this will allow you to visit, stay over and spend more time with the second household
  • the second household can be of any size; and
  • both households should not be part of more than one bubble and should continue to socially distance outside the bubble.

You can find more information on support bubbles on the following page:

People who are shielding remain vulnerable and should continue to take precautions.  It is still best to stay at home as much as possible until shielding is paused.

Pausing of shielding guidance

From 31 July, it is anticipated that shielding for extremely vulnerable people will be paused. More information is available on the following page:

Scotland

The Scottish Government has sent out letters to those at high risk of severe illness from coronavirus. If you’ve had one of these letters, these are the things you need to do:

  • stay at home as much as you can, until at least 31 July
  • avoid going places that are indoors
  • keep 2 metres away from people, even those you live with
  • if you have not already, send your Community Health Index (CHI) number to the SMS Shielding Service – both your CHI number and the mobile number for the SMS Shielding Service are in the letter

Going outdoors

As long as you do not live in a residential care or nursing home, you can:

  • go out for things like a walk, wheel, run or cycle, as much as you want
  • meet in a group of up to 8 people outdoors – try to avoid meeting with people from different households on the same day
  • travel in a car, either driving yourself or being driven by someone you live with – try not to go in a car with people you do not live with
  • take part in a non-contact sport or activity, such as golf, angling or outdoor swimming

When outdoors, you should:

  • try to avoid touching objects and surfaces
  • stay within your local area – this is roughly within 5 miles of your house
  • maintain strict physical distancing, also known as social distancing, at all times, even if you’re out with someone you live with, or with your usual carer
  • try to choose times and areas that are quiet
  • stay close to home so you do not have to use a toilet that is not your own
  • wash your hands for at least 20 seconds as soon as you get back home

How shielding might change in the future

You need to have the right information to fully understand individual risks. This will help you to decide things like whether to go to the shops or ask family and friends to visit. This helps you to take back more control over their lives while still staying safe.

Over the summer, the Scottish Government will work towards:

  • giving people updated clinical evidence about their conditions and what that means for their risk from coronavirus
  • helping people to understand the changing infection rate in their local area
  • giving this information in a way that is accessible, understandable and is helpful
  • giving access to support to help people make informed choices about their lives
  • supporting people to put their choices into practice

Keeping up-to-date with changes to shielding

The Government will keep giving updates, so that you know what is happening and what to expect. It will contact those who have been asked to shield about any changes to the advice before the end of July. This will be by letter and through the SMS Shielding Service to send updates to mobile phones.

More information can be found here:

https://www.gov.scot/publications/covid-shielding/pages/overview/

 

 

 

 

 

 

 

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Introduction

The Brain Tumour Data Dashboard lets you explore up -to-date, population level data about the brain tumours diagnosed in England between 2013 and 2015. Using the drop down menus on the left you can select different groups of patients to view in the charts below. In these charts the number of patients for every 100 diagnoses is displayed as images of people. Patients have been grouped by date of diagnosis, type of tumour, age, gender, and region in England.

For each group of patients you can explore the different routes to diagnosis, the proportion of those who received chemotherapy or radiotherapy, as well as the survival of the patients within each group. For more information about what these metrics mean please see the glossary.

How to use

  1. Select the year of diagnosis using the drop down menu.
  2. Select your patient group of interest from the four drop down menus in the following order:
    1. Tumour group
    2. Age at diagnosis
    3. Region of England
    4. Gender of patient
  3. To view a second chart to compare different groups of patients, click the ‘compare’ button.The second chart will appear below the first chart.

*Note that the tool is best used on a laptop or tablet rather than a mobile phone*

Unavailable data

Some of the data in these charts is not available.There are two main reasons for this:

  1. How the data has been grouped

If you cannot select a patient group from the drop down menus, the data is unavailable because of how the data has been organised.

Public Health England has grouped the data like a branching tree. The bottom of the tree contains all the patients with brain tumours, and then each branch divides the data by a certain characteristics, like age, or location of tumour. But the data is divided in an order, starting with location of the tumour (endocrine or brain), then by age, region, and gender. Age is at the start because it makes a bigger difference to survival rates and treatment rates than gender or region. Sometimes, after the data has been split by type of tumour and age, there is not enough data to be split again. This is because to protect patient confidentiality groups cannot contain less than 100 patients. Because some groups cannot be split further, you cannot create ‘totals’ for everyone by region or gender. For example, you cannot see results for all ages by region, or all brain tumours by gender. If these totals were calculated and released, it might be possible to identify patients, which is why Public Health England cannot release this data.

  1. Statistical reasons and data availability

If you can select a patient group from the chart menus, but the chart does not display, the data is unavailable for one of several reasons:

  1. Data is not yet available for the selected year from Public Health England.
  2. Data is not available because the data quality is too poor to release this statistic.
  3. Data is not available as the statistic is not appropriate for this group.
  4. Data is not available because the standard error of the estimate was greater than 20% and so the estimate has been supressed.

Up to date brain tumour data

Brain tumour data may influence the decisions you make about your care. Data also helps you understand the bigger picture, or landscape, in which you find yourself.

Brain tumour data and statistics influence the focus, and work of organisations like brainstrust. The information helps us to understand the scale and impact of the problems we are setting out to solve.

This tool helps you understand the landscape in which you find yourself having been diagnosed with a brain tumour. This landscape can be particularly tricky to navigate as there are many different types of brain tumour, all of which have a different impact.

The information you see represents the most up-to-date, official, population level brain tumour data available for England. Over time we will be adding to the brain tumour data available and publishing reports, with recommendations, as a result of what we learn from this data.

The data behind this content has come from Public Health England’s National Cancer Registration and Analysis Service (NCRAS) and is a direct result of the ‘Get Data Out’ project.

This project provides anonymised population level brain tumour data for public use in the form of standard output tables, accessible here: http://cancerdata.nhs.uk/standardoutput

Incidence

The number or rate (per head of population) of new cases of a disease diagnosed in a given population during a specified time period (usually a calendar year). The crude rate is the total number of cases divided by the mid-year population, usually expressed per 100,000 population.

Malignant

Malignant tumours which grow by invasion into surrounding tissues and have the ability to metastasise to distant sites

Mortality

The number or rate (per head of population) of deaths in a given population during a specified time period (usually a calendar year). The crude rate is the total number of deaths divided by the mid-year population, usually expressed per 100,000 population.

Non-malignant

Not cancerous. Non-malignant tumours may grow larger but do not spread to other parts of the body.

Survival

The length of time from the date of diagnosis for a disease, such as cancer, that patients diagnosed with the disease are still alive. In a clinical trial, measuring the survival is one way to see how well a new treatment works. Also called ‘overall survival’ or ‘OS’.

Routes to Diagnosis

Under the ‘Routes to Diagnosis’ tab in the Brain Tumour Data Dashboard, you can explore the ways patients have been diagnosed with brain tumours. There are many ways, or routes, for cancers to be diagnosed in the NHS. A ‘route to diagnosis’ is the series of events between a patient and the healthcare system that leads to a diagnosis of cancer. The routes include:

  1. Two Week Wait

Patients are urgently referred by their GP for suspected cancer via the Two Week Wait system and are seen by a specialist within 2 weeks where they are diagnosed.

  1. GP referral

Diagnosis via a GP referral includes routine and urgent referrals where the patient was not referred under the Two Week Wait system.

  1. Emergency Presentation

Cancers can be diagnosed via emergency situations such as via A&E, emergency GP referral, emergency transfer or emergency admission.

  1. Outpatient

Outpatient cancer diagnoses include diagnoses via an elective route which started with an outpatient appointment that is either a self-referral or consultant to consultant referral. (It does not include those under the Two Week Wait referral system).

  1. Inpatient elective

Diagnosis via an inpatient elective route is where diagnosis occurs after the patient has been admitted into secondary care from a waiting list, or where the admission is booked or planned.

  1. Death Certificate Only

Diagnoses made by Death Certificate Only are made where there is no more information about the cancer diagnosis other than the cancer related death notifications. The date of diagnosis is the same as that of the date of death.

  1. Unknown

For some patients with a cancer diagnosis, there is no relevant data available to understand the route to diagnosis.

 

More information

If any of the statistical terms in this section of the brainstrust website are hard to understand, we recommend looking them up here:

Cancer Research UK’s Cancer Statistics Explained

http://www.cancerresearchuk.org/health-professional/cancer-statistics/cancer-stats-explained/statistics-terminology-explained#heading-Seven

If you are looking for help understanding terms relating specifically to brain tumours, and treatment, then the brainstrust glossary is available here:

https://www.brainstrust.org.uk/advice-glossary.php