Question for anyone shielding in Scotland

[Froggie70]

Hello

Has anyone in Scotland received an official shielding letter where the only medication they take is Methotrexate and they have no other comorbidites?

There is a bit of a dispute between my Rheumy nurse and GP. Rheumatology say I should have a letter as I am on 22.5mg but it’s not controlling my flares but GP says no as Methotrexate is not one of the 5 drugs noted in their list from Public Health Scotland.

I’ve got the flowcharts for English hospitals that people have kindly posted on this site but can’t see anything for Scotland.

I wouldn’t be so concerned if it weren’t for the fact that work will be expecting me back in soon (won’t provide me with a laptop) and I need to travel on public transport.

Thanks

[jane1964]

Hello I can't help as to who is correct but you could ask consultant via their secretary if they will issue a letter.I got a letter from my consultant.My GP hadn't done one but took a copy of the consultant letter and noted it.In my case the consultant knows a lot more about my illness, as it's a relatively new GP to me and he's only known me when I'm relatively well thanks to the help of the consultant with immunosuppressant treatment!

[Froggie70 in reply to jane1964]

Hi Jane. Good idea, will give them a phone and cut to the chase. Thanks for replying. Take care🙂

[happytulip in reply to Froggie70]

I agree with Jane. Your Rheumatologist knows your condition the best AND the MTX isn't controlling your symptoms so if you did contract Covid then you could potentially become very sick.

Speak to the rheumie or the secretary and insist that they have a duty of care to get you a letter x

[Froggie70 in reply to happytulip]

Hi there thanks for your response happy, I’ve just created a new post you might be interested in. Take care 🤗

[Paul_Howard Partner LUPUS UK]

Hi Froggie70 ,

Further to our discussion in private messages;

Methotrexate is listed as one of the immunosuppressive agents that increases risk in the guidance issued by the British Society for Rheumatology - rheumatology.org.uk/Portals...

Further to that, I've just checked the Scottish Government's guidance and methotrexate is also included at one of the immunosuppressant treatments - gov.scot/publications/covid...

[Froggie70 in reply to Paul_Howard]

Hi Paul, thanks for coming back to me. I honestly don’t know what’s going on with GP and now the hospital. I was more or less told yesterday that I’m in the same category as a healthy person with no illness.

Thanks for checking.

[Froggie70 in reply to Paul_Howard]

Hi Paul,

Your second link is the one the GP sent to me and he read this as MTX not being considered a drug that would put anyone in a risk category. Think this is the problem it’s down to interpretation. But it does seem like the hospital Rheumatology department are taking the same view. Interesting to see if this is just an individual health board or if the message is starting to change as lockdown eases.

Thanks again.

[Paul_Howard Partner LUPUS UK in reply to Froggie70]

When reading the information on that link, it is important to bear in mind that there are more than two risk categories, not just 'high risk/shield' and 'low risk/standard social distancing'. Whilst methotrexate alone wouldn't place you in the 'high risk/shield' group, it doesn't mean you are not at an additional risk to the rest of the population. This is the 'moderate risk' group who are advised to follow 'strict social distancing'.

[Froggie70 in reply to Paul_Howard]

Thanks Paul I agree.

[heatherevans28]

I would agree in saying that this would put you in the moderate risk group, not the shielding group. These people are not getting shielding letters in Scotland, as that is not the current advice. They should instead be strictly social distancing, and will not get any written confirmation of this from the government or their doctor. There is however a guidance document specifically for rheumatic conditions which you can download. It doesn't say much about work sadly. gov.scot/publications/coron...

I should note that all letters in Scotland are coming from a central body and Doctors are reporting to them if they think you should have received one but haven't. They are not issuing them personally, unlike in England where I understand this is happening in some areas.

In terms of your work, I'm not sure which sector you work in so cannot link the specific advice. Only specific sectors are allowed to return in phase 1. The general advice however is that employers need to 'be responsible' and should still be working from home if possible. Part of this is: 'Employers and employees should discuss their working arrangements, including with trades unions where present, and employers should take every possible step to facilitate their employees working from home, including providing suitable IT and equipment to enable remote working.' gov.scot/publications/coron...

From this advice it seems not having enough laptops is not really a sufficient excuse to make employees return to work early. They should be informed that you are in the moderate group, the same as anyone with diabetes etc. They might have procedures in place for these people already or would otherwise need to do an individual risk assessment with OH or HR which will include your travel arrangements.

Hope this helps x

[Froggie70 in reply to heatherevans28]

Hello this is excellent, thank you. This is will be a real help for my next conversation with my boss.

Take care and thanks again 🤗