Protection Levels And Vitamin D Offer Letter - 23 October 2020: Bsl Version

21st December 2020

This is a subtitled BSL version of a letter sent to people on the shielding list on 23 October 2020. The letter covers the introduction of Protection Levels in Scotland. It also has wellbeing information, including an offer for vitamin D supplements.
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Dear [Patient],
You are receiving this letter because we have asked you to shield previously or we have recently added you to the list of those considered at higher risk from coronavirus (COVID-19).
Since the beginning of the pandemic 7 months ago, we have taken many steps to protect you and others. We said that if case numbers started to rise, we would take even more steps to stop the virus spreading.
Protection levels for Scotland

As you know, cases are now rising across Scotland. To keep you safe, the First Minister has announced that we will have 5 protection levels in Scotland.
Protection levels will be set in response to infection data in local areas. There is different guidance for each protection level. You should follow the guidance for your area's protection level. The protection level for your area will soon be available at www.gov.scot/coronavirus. The levels will apply from Monday 2 November.
Extra advice for people considered at higher risk from coronavirus

You should follow the protection level guidance for the general population as a minimum. We are also giving you extra advice for areas like work, school, shopping and contact with others. You can find this extra advice in the table that comes with this letter.
We believe that you should be able to make decisions for your own situation. This means thinking about the number of cases in your local area, your own health situation, advice from your GP, consultant or clinician, and the risk different activities carry. To help you do this, we will shortly send you a guide to developing a practical protection plan which is right for you.
The NHS is open for everyone
Looking after your health and wellbeing is important. The NHS is open for everyone, not just for coronavirus patients. Keep your medical appointments and let your GP or consultant know about any new illnesses or issues you have. Hospitals and GP surgeries have taken steps to reduce the risk of coronavirus and make sure your visits are safe.
Please read the rest of this letter for more information on what the new protection levels mean for those more at risk of coronavirus. There is also information about free vitamin D supplements and a reminder about flu vaccinations.
Yours sincerely,
Professor Marion Bain

on behalf of

DR GREGOR SMITH
INTERIM CHIEF MEDICAL OFFICER

Vitamin D

Everyone in Scotland should consider taking a daily supplement of 10 micrograms of vitamin D to help keep bones and muscles healthy. This is particularly important over the winter months.

We are offering you a free supply of vitamin D

If you were shielding inside until 19 June this year, you may have had less sunlight than usual this summer. This could have an impact on your vitamin D levels although you will have built up levels of vitamin D if you have been outside since then. If you opt in to this offer, we will post you a 4-month supply of daily doses of vitamin D to your home address from December.

People who should seek advice before taking a vitamin D supplement

For most people taking a 10-microgram supplement of vitamin D daily is safe. But there are some who should seek advice first due to certain health conditions or medication. This is because taking too much vitamin D can cause calcium to build up in your body and this can weaken your bones and damage your heart and kidneys.
You should seek advice from your GP, pharmacist, midwife or health visitor if you:

have known hypercalcaemia (high levels of calcium in the blood - this can be associated with high levels of parathyroid hormone, kidney stones, certain cancers, and chronic kidney disease)
have sarcoidosis (an inflammatory condition which can affect various parts of the body including the lungs and glands)
take digoxin
take calcium or other vitamin supplements already

Groups more at risk of vitamin D deficiency
Groups at higher risk of having too little vitamin D include:
people who have low or no exposure to the sun, for example if you spend most of your time indoors or cover your skin for cultural reasons
people from minority ethnic groups with dark skin such as those of African, African-Caribbean and South Asian origin, who require more sun exposure to make as much vitamin D
all pregnant and breastfeeding women
infants and children under 5 years old

Further information on vitamin D is available in a range of languages at www.healthscotland.com/documents/5274.aspx.

How to get your free supply of vitamin D
Use our text messaging service
If you have already joined the Scottish Government text messaging service, get your free vitamin D by texting VITD to 07860 064525 from your mobile phone.
If you would like to join our text messaging service
Join the free Scottish Government text messaging service by sending a text from your mobile phone with your Community Health Index (CHI) number to 07860 064525. Your CHI number is the 10-digit number shown at the top of this letter.
After you have done this, text VITD to 07860 064525 to get your free vitamin D.
Call the free national helpline number
If you prefer to phone, you or someone you know can call the free national helpline number on 0800 111 4000 (Monday to Friday, 9am to 5pm). This will put you through to your local authority who can take your name, address and CHI number.
Opt in for the vitamin D as soon as possible
Text or call us as soon as possible and by Wednesday 11 November at the latest. We want to make sure you can get your supply at the start of December. Stocks are limited but we will aim to send vitamin D to as many of you as we can. You can also buy vitamin D supplements from most supermarkets, community pharmacies or online. 

Why taking vitamin D over the winter months is important

Our main source of vitamin D is sunlight. In Scotland, we only get enough of the right kind of sunlight for our bodies to make vitamin D during roughly half the year (April to September). From October to March, we rely on food and supplements to get enough vitamin D. Only a small number of foods contain vitamin D, such as oily fish, red meat and egg yolks, so it is difficult to get enough from food alone.

Without enough vitamin D, children can be at risk of developing rickets, which causes weak and badly formed bones. In adulthood and later life, a lack of vitamin D can lead to osteomalacia (softening of the bones) and a greater risk of broken bones.
If you are resident in a care home

If you are a resident in a care home, your GP or nurse will discuss with you whether vitamin D will be of benefit to you.

Flu vaccine
You should get a letter inviting you and anyone you live with for a free flu vaccine. It is important that you get this vaccine. Travel to and from a vaccination centre counts as essential travel. The flu vaccine will not protect against coronavirus, but it will help protect against this year's flu.
Contact your GP if you have not received a letter in the next few weeks.

Keep up to date with SMS alerts
To join the free text messaging service from the Scottish Government, send a text from your mobile phone with your Community Health Index (CHI) number to 07860 064525. You will only hear from us when there is important information you need to know.
Your CHI number is the 10-digit number at the top of this letter. You do not need to text any other information.
You can also get information from the free national helpline on 0800 111 4000 (Monday to Friday, 9am to 5pm) if you do not have access to a mobile phone.

Data Protection Statement
You have been identified from either your GP practice, local Health Board or securely stored national data in order that we could write to you. We want to reassure you that this information has only been shared in a limited way within the NHS in Scotland and did not include your medical record. During this time, we will keep your contact details in case we need to contact you again. We will also notify your GP and your Health Board that you have been contacted in order that they can provide appropriate support. To provide some of the support noted above, we may share your contact details only with your council. This is only so that they can support you during this difficult time. This action is only being taken due to the current COVID-19 outbreak. We want to assure you that your local council would not receive any details of your medical condition or health record.
You can request your contact details to be removed from the shielding list by asking your GP or hospital clinician.


How to request this information in a different format
Other formats of this letter may be available on request. If you or someone you know needs this information in a different format or language, please email phs.healthdata@phs.scot. Use the subject line ‘translation request’.

Please include these details about the person who needs the different format:

name
address and postcode
CHI number
format or language required

Please also tell us if we should send information in this format in future.

If you prefer, you can call the national helpline on 0800 111 4000 with this information. The helpline is open Monday to Friday, from 9am to 5pm.