Rehabilitation following Covid-19

Information for patients

Contents Introduction ................................................................................................................................................... 3

Hand Hygiene ............................................................................................................................................... 3

Common problems after Covid-19 ................................................................................................................ 5

Physical: ................................................................................................................................................... 5

Psychological: ........................................................................................................................................... 5

Breathlessness and Breathing Control .......................................................................................................... 6

Positions to help ease breathlessness ...................................................................................................... 6

Techniques to Help Breathlessness.............................................................................................................. 7

Breathing Control - Helps you relax ........................................................................................................... 7

Pursed Lip Breathing- For activities that make you feel short of breath ..................................................... 7

Blow as you Go- For activities that make you breathless .......................................................................... 7

Paced Breathing- Use when you are walking or climbing stairs ................................................................. 7

Breathing Techniques: ‘The Active Cycle of Breathing’ (ACBT) ............................................................... 8

Managing Phlegm- Other recommendations ............................................................................................. 9

Nutrition- Why is it important? ..................................................................................................................... 10

Tips for making the most of your food ..................................................................................................... 10

Oral Nutritional Supplements .................................................................................................................. 11

More information and support: ................................................................................................................ 11

Speaking and Swallowing ........................................................................................................................... 12

Speech and Voice ................................................................................................................................... 12

Swallowing .............................................................................................................................................. 12

Increasing my Activity: What can I do? ....................................................................................................... 13

Setting goals for recovery ....................................................................................................................... 13

Important things to remember before exercising ..................................................................................... 13

Bed Exercises ......................................................................................................................................... 14

Chair Exercises ....................................................................................................................................... 15

Standing Exercises ................................................................................................................................. 16

Guide to Physical Activities ......................................................................................................................... 17

Exercise Activity Log ............................................................................................................................... 18

How to Manage my Energy ........................................................................................................................ 19

The 3 P’s of Energy Management ........................................................................................................... 19

Energy Saving Tips ................................................................................................................................. 19

Being Discharged from Hospital ................................................................................................................. 21

Isolation Guidelines After Discharge ........................................................................................................... 21

Managing the Psychological Impact of Covid-19......................................................................................... 22

Managing psychological wellbeing .......................................................................................................... 22

Check in with yourself ............................................................................................................................. 22

When you may need professional help ................................................................................................... 23

Getting Help ............................................................................................................................................... 25

Useful Community Links ............................................................................................................................. 26

Introduction

Life after illness can be challenging and it can feel like a series of ‘stepping stones’ to feel “normal” again. This process can take time, effort and energy for you and your loved ones. Remember to allow yourself the time you need to go through the recovery phase.

This leaflet has been designed to provide you with information on Covid-19 and what you can do to help aid your recovery whilst you are in hospital and once you are home.

Covid-19 is a new type of coronavirus which predominately affects the airways. This causes shortness of breath, coughing and sometimes the level of oxygen in the blood goes down.

Hand Hygiene

DO

Wash your hands with soap and water often and for at least 20 seconds

Use hand sanitiser gel if soap and water are not available

Wash your hands as soon as you get home

Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze

Put used tissues in the bin immediately and wash your hands afterwards

Please refer to guidance about rubbish disposal on your local council website

DON’T

Do not touch your eyes, nose or mouth if your hands are not clean

Common problems after Covid-19

Physical:

Muscle weakness – being unwell often means staying in bed or resting more, this can lead to muscle weakness.

Reduced amount of moving or walking – this can put you at risk of losing muscle and strength.

Breathlessness – breathlessness is a key feature for many people after Covid-19. If you have had Covid-19 you may notice that you become short of breath doing every day tasks – this is as your lungs work harder to get oxygen to your body. You may notice that you are breathing faster or taking smaller breaths.

Phlegm – most people cough and clear phlegm, (otherwise known as mucus or secretions) throughout the day without noticing. With Covid-19 you may have a dry cough, but some people cough up phlegm during the course of their illness. This can depend on your underlying health conditions, or may just be how the virus affects you. Clearing this phlegm is important as it will improve your oxygen levels and help make your breathing easier.

Fatigue – being unwell and recovering from this illness may leave you feeling very tired. You may feel you need to sleep more or feel exhausted after doing a simple task.

Reduced physical fitness – all of the above problems can have an impact on how much you can do each day and how far you are able to walk.

Psychological:

Delirium – delirium is a sign that someone is physically unwell. People may feel ‘confused’ at times, but then seem their normal self at other times. People who are delirious may not know where they are or believe they are somewhere else. They might see things that other people can’t see, or believe things that aren’t true. Delirium normally improves as the individual gets better.

Fear or anxiety – some people who have been very unwell may feel anxious as they physically improve. For people who have been confused with delirium, they may feel frightened or embarrassed afterwards. It may help to talk to your loved ones to help you make sense of why you feel like this.

Thinking and memory – after being unwell, some people may have problems with their memory or how long they can concentrate. You might find yourself forgetting things that previously you would have remembered. This is common and will often get better over time.

Breathlessness and Breathing Control

After an illness that affects the lungs, many people often feel short of breath. Everyday tasks, such as walking, dressing or climbing the stairs might be making you feel breathless.

Breathlessness can be frightening, but it is important to try to remain calm, as anxiety can make your breathing and heart rate increase further.

It is also important not to completely avoid all movement, as steadily increasing your activity will help your return to your usual routine. Instead try using the following techniques to help you manage the control of your breathing.

Positions to help ease breathlessness The muscles you use to breathe are the same muscles that support your shoulders and neck. These positions help to support your shoulders so that your muscles can be used only for breathing.

Try out some of the supportive positions below and see which works best for you. This may change over the course of a day; it is about what feels right at the time.

Techniques to Help Breathlessness

Breathing Control - Helps you relax

Get in a comfortable position

Breathe in and out gently through your nose (or out through your mouth if you need to)

Focus on breathing slowly and breathing out any tension in your body. Closing your eyes may help you to focus

You may want to rest a hand on your stomach, feel your hand rise as you breathe in.

Pursed Lip Breathing- For activities that make you feel short of breath

Breathe in gently through your nose.

Breathe out through pursed lips, like you are blowing out a candle.

Breathe out for as long as comfortable; do not force your lungs to empty.

Blow as you Go- For activities that make you breathless

Breathe in before you make the effort.

Breathe out as you make the effort (e.g. lifting the object/ bending forward). This should be on the hardest part of the movement.

Paced Breathing- Use when you are walking or climbing stairs

Pace your breathing by counting to yourself whilst doing an activity.

Try on the stairs: o Breathe in for 1 step, Breathe out for 2-3 steps.

You can count for longer as you breathe in or out if that feels better for you.

Can also be used when walking.

Breathing Techniques: ‘The Active Cycle of Breathing’ (ACBT) ACBT is a breathing technique that helps to loosen and clear mucus from the lungs, improve ventilation in the lungs and improve the efficiency of your cough.

Breathing control ‘Belly Breathing.’ This is gentle normal breathing using your stomach. Put your hands on your stomach. As you breathe in you should feel your hands rise and as you breathe out your hands should fall. Your breathing should be slow and steady.

Deep breaths Focus is on taking a deep breath in, slowly through your nose, hold your breath for 1-3seconds, followed by a gentle relaxed breath out through your mouth.

Huffs Take a big breath in, keep your mouth open and imagine steaming up a mirror with force. Huff all the air out of your lungs. (Use breathing control between huffs to avoid getting breathless.)

Cough Try a big strong cough if you think you have phlegm on your chest to clear. If this is painful, try hugging a pillow tightly when coughing.

If you don’t have any phlegm to cough up, then concentrate on cycles of breathing control and deep breathing.

Managing Phlegm- Other recommendations

DO

Keep hydrated - drink lots of water based fluids

Change your position regularly - to help move the phlegm. You can include short periods of time lying on either side. An upright sitting position can help with effective coughing and deep breaths.

Move around - even a gentle walk around your house can help clear phlegm Move as much as your energy allows.

Seek support - from your GP if your symptoms persist or you notice a significant change in the colour of your phlegm.

DON’T

Avoid coughing or clearing your phlegm if you experience pain on coughing; speak to your GP or health professional for advice.

Become exhausted or dizzy trying to clear your phlegm.

OXYGEN

It is possible that you may have required oxygen during your stay in hospital and that you may also have been sent home with it. The decision to keep you on oxygen will have been made by specialist doctors, who will have looked at the levels of oxygen in your blood and where these levels are low, prescribed you oxygen.

It is important to be aware that oxygen is NOT used to treat breathlessness, therefore it is possible that your breathless has improved, however you may still require oxygen, or that you are feeling more breathless than usual, but the levels of oxygen in your blood are ok.

Your need for ongoing oxygen MUST be assessed by a Respiratory Consultant or Specialist Respiratory Nurse. If you have not had a review since being home from hospital, please speak with you GP or visiting Healthcare Professional, who can follow this up for you.

Nutrition- Why is it important?

It is important to be aware of your weight and appetite, particularly if you are older or have a pre-existing medical condition. However, if you continue to lose weight or you struggle to eat enough, even if you are overweight, ask a healthcare professional for advice.

Following an illness, your body needs energy to recover, which it gets from the foods we eat. It can however be difficult to eat enough, as your appetite may have reduced. It is important that you are consuming the right amounts of the right nutrients to prevent unintentional weight loss.

Tips for making the most of your food

Eating well when you’ve lost your appetite can be difficult; you could try some of the ideas listed here to help you get the most out of the foods you eat while you are unwell and may help you to regain some of the weight or strength you have lost:

If you have diabetes or heart disease, some of the tips above may not be suitable for you. Speak to your Healthcare Professional for further advice.

Eat more of the foods that you enjoy at the times of day when you feel more like eating

Eat smaller meals with snacks

Include a minimum of two nourishing drinks (eg smoothies, soups, fruit juice, milkshakes or hot chocolate) in between meals

Avoid drinking before of during meals, as the liquid can fill you up

Add ingredients such as cream, cheese, butter, olive oil, cream cheese, milk powder and ground almonds to foods like soups, stews, curries, scrambled eggs, vegetables and potatoes

Add honey, syrup and jams to porridge, milky puddings, on bread, toast or tea cakes

Fortify your usual milk by whisking 2-4 tablespoons of skimmed milk powder into 1 pint of milk

If you usually use low fat, low sugar ‘diet’ foods and drinks, switch to the no-diet ones (eg whole milk) and have some treats such as a piece of cake, chocolate, a handful of nuts, or a biscuit between meals or as a snack

Powdered nutritional supplement drinks mixed with fresh milk are available from most supermarkets and pharmacies as well as online, and can be used between meals to help you get the extra nutrition you need whilst you are feeling unwell or recovering

The Eatwell Guide- this shows you the types of food and proportions you should be eating for a balanced diet. More detail can be found at:

www.nhs.uk/live-well/eat-well/the-eatwell-guide

Oral Nutritional Supplements

If you have recently been discharged from hospital, you are struggling to manage to eat enough and/or if you are thin or feeling weak your Healthcare Professional may feel that you need extra nutrition to meet your energy and nutrient needs and may prescribe nutrition drinks called ‘oral nutritional supplements’. You may only need oral nutritional supplements for a short time for example until you are able to eat enough to meet your needs. Please liaise with your GP for a prescription.

More information and support:

British Dietetic Association Covid-19 advice:

www.bda.uk.com/resource/covid-19-corona-virus-advice-for-the-general-public.html

The free leaflet ‘Your Guide to Making the Most of Your Food’ contains more tips and ideas to help you get the most nutrition from your food: https://www.malnutritionpathway.co.uk/leaflets-patients-and-carers

If you require support accessing hot meals at home, you can either contact Adult Social services or go via Government website: www.gov.uk/meals-home

Speaking and Swallowing

Speech and Voice

You may experience some short-term changes to the sound of your voice caused by persistent coughing. When speaking, it might feel harder to produce your voice and speaking quickly could feel uncomfortable. These changes are similar to the changes you would expect to experience with a cold or flu but may be more intense and last longer after coronavirus.

These changes may take 6-8 weeks to get better from the start of your COVID symptoms. If after this time your voice has not returned to normal, please contact your GP as you may need further support from a voice specialist clinic.

Swallowing

When eating and drinking, you need to control your breathing and swallowing carefully. If you are short of breath, or coughing when eating and drinking, you might find food and drink goes down the wrong way. You may need to change your eating and drinking routine whilst you are recovering:

Always sit up fully for any food or drink

Eat or drink at a slower pace

Stop and rest if you are feeling breathless or tired

Try and eat smaller amounts often throughout the day, rather than three normal meals

Take small sips or bites

If you are getting tired or out of breath when chewing, try eating softer foods which need to be chewed less

If you have serious swallowing problems, you might need a feeding tube to give you food and drink whilst you are getting better. This might mean that you need an assessment from a Speech and Language Therapist to support you to swallow safely. You can be referred by the ward, or via your GP once you are home.

Increasing my Activity: What can I do?

The best thing you can do for your recovery is to start moving. Start with your normal daily activities:

Get up at a normal hour and try to get a good nights sleep

Get washed and dressed each day, even if this takes time

If you are tired, go back to bed for a sleep, but set an alarm so that you have a reminder to get back up again

Stand up from your chair at least once per hour and if you are safe to, move around.

Start trying to do simple tasks around the house like making a sandwich or a drink

Build up to longer/ slightly harder tasks like helping prepare a main meal

Do your exercises every day

Setting goals for recovery

It is important to be patient and stay positive. By breaking a goal down into smaller, bite sized chunks; it can help the ultimate aim feel more achievable.

You may like to set yourself small goals to reach by the end of each week. These can be physical or mental or both. Reflecting back on your achievements can be encouraging, but try to remember to make your goals achievable and most importantly, based around what is important to you.

Important things to remember before exercising Whilst you were unwell, your body will have used energy needed to survive from stores in your muscles. When you combine this with reduced activity levels, your muscles may be smaller and weaker.

Activities may seem harder and more tiring than you are used to. Patients have found this could lead to them becoming increasingly inactive, or catching up on jobs when they had a good day, which then lead to a flare-up of pain or general weakness and the need to rest for a few days.

This can feel frustrating and like you’re not improving. Make sure you pace yourself—little and often is the best course of action.

GOAL: TO SPEND 5 MINS IN MY GARDEN

My family supported me to put a chair outside and to walk out of my back door.

I took a rest to ensure I paced myself

I sat down to make myself breakfast

I got up and dressed slowly

Bed Exercises

Chair Exercises Getting out into the chair when you’re ready will greatly benefit your lungs, muscles, circulation and digestive system.

Standing Exercises Hold onto a firm surface for all standing exercises, for example, a kitchen work surface. Not all exercises need to be done at once to break them down into manageable sessions.

Guide to Physical Activities

This is a scale that asks you to rate the difficulty of your breathing, please use it to help with monitoring your breathlessness while exercising.

You could use this to score how well your lungs are recovering.

It is important to take regular rests and stop before you get too short of breath.

You should be aiming to exercise within zones 3-5 on this scale.

It is normal to be out of breath and for your heart rate to increase with exercise and walking, but this should return to normal within five minutes after finishing.

Exercising at moderate levels will help increase your endurance, energy stores and lung function.

If you keep a record of your scores and activities using the activity log on the next page, you should be able to notice improvements over time.

Exercise Activity Log

Weeks after hospital discharge

Day 1 / Mins walked

Day 2/ Mins walked

Day 3/ Mins walked

Day 4/ Mins walked

Day 5/ Mins walked

Day 6/ Mins walked

Day 7/ Mins walked

Week 1 Walk 1 Breathless score Walk 2

-------- -------- -------- -------- -------- -------- --------

Week 2 Walk 1 Breathless score Walk 2

-------- -------- -------- -------- -------- -------- --------

Week 3 Walk 1 Breathless score Walk 2

-------- -------- -------- -------- -------- -------- --------

Week 4 Walk 1 Breathless score Walk 2

-------- -------- -------- -------- ------- ———- ———-

How to Manage my Energy

It is very common when recovering from Covid-19, to feel extremely fatigued. Simple tasks may cause you to become breathless and feel very tired.

Energy conservation isn’t about avoiding movement all together, as if done wisely, exercise is needed to help you return to your normal activities. Instead, it is about saving your energy throughout the day, so that you have enough of it to do the things you want to.

‘How to conserve your energy’ guide: www.rcot.co.uk/conserving-energy

The 3 P’s of Energy Management

Prioritise

Decide which jobs are absolutely necessary and which jobs can be left or given to someone else.

Plan

Plan ahead – think about what you have to do that day or week and spread the tasks out, avoid doing them all at once.

Simplify tasks – break them down into small chunks and take rests.

Time do the heavier tasks when you have the most energy.

Identify if the task can be adapted or if you can use equipment to help you save energy- see next page for ideas.

Pace

Pace all work to your breathing- see earlier section on this.

Take your time and set yourself small goals.

Alternate between easy and difficult activities.

Save energy-sit to do some tasks and take regular breaks / rest often.

Don’t overdo it on ‘good days’ and pay the price on ‘bad days’.

Energy Saving Tips

Sit down when doing tasks (getting washed, dressed or preparing food). Position chairs around your house and consider a stool in the shower or bath

Avoid bending too often. When you do need to bend forward (ie. to put socks on) try breathing out or ‘Blow as you Go’ down. Consider equipment like a long handled grabber/ shoe horn.

Limit reaching your arms above your head by:

- Positioning items at easy to reach heights in your kitchen.

- Sit in a towel bathrobe to dry off after showering

Use Equipment to help save energy – some ideas are:

o Use an electric toothbrush/ razor.

o Use a microwave for meals.

o Use a dishwasher to wash up.

o Use the bannisters on your stairs or stair lift if you have one.

Do you need temporary equipment like a walking aid, grab rails or raised seating? An Occupational Therapist can assess your needs for temporary or long term equipment:

Contact your GP or Adult Social Services team for advice.

Ask for help - Don’t be afraid to ask people you live with to support you with things like the cooking, cleaning or shopping.

Being Discharged from Hospital

During your stay in hospital you will likely be assessed and treated by an Occupational Therapist. They will establish how you managed your activities of daily living before you got ill – such as washing and dressing yourself, managing meals and shopping. They will work with you to try and regain this level of ability. When you are well enough to leave the hospital, they will discuss with you how you will cope when you get home and what support you may need. They may also provide you with some equipment that enables you to manage as independently as possible when you first get home.

Your medication may have been changed from what you were taking prior to your admission. A supply of tablets will be given to you before you leave the hospital with information and instructions. Your GP will prescribe the medications you need. Please discuss any concerns you have regarding your medication with the medical team.

If you feel there will be a difficulty with your relatives or friends collecting you or your travel home, please discuss this with your nurse.

Isolation Guidelines After Discharge

How long until I can go out again?

Once home, you should self isolate for 14 days after the onset of symptoms in order to minimise transmission. This is longer than the 7 days of isolation for individual who remain at home with symptoms, since those admitted to hospital have a higher viral load at the time of illness (meaning you are contagious for a longer period).

Please discuss your particular case with the Doctor discharging you before you leave the hospital.

Can I go out for my daily allowed exercise when home?

Please discuss this with the Doctor discharging you before you leave the hospital.

Managing the Psychological Impact of Covid-19

Being unwell can have an impact on your sense of wellbeing, and recovery from Covid-19 is no exception. It can be normal to feel low in mood, deflated and lacking in energy and motivation.

Unfortunately, some people will experience more persistent and more intense feelings and some are more vulnerable to this than others. Witnessing the suffering of others can equally have a serious effect on wellbeing, particularly where this is experienced over a period of time.

Managing psychological wellbeing

Below are a series of hints and tips for managing wellbeing.

Try to keep a daily routine as much as possible.

When setting expectations for yourself think: realistic and achievable. Setting too high

expectations too quickly may cause you to feel unnecessarily bad about yourself and lead

to unhelpful patterns of thinking.

Eat healthy nutritious food and stay hydrated. If you have difficulty eating this can be a sign

something is wrong and you may need to a appropriate professional advice.

Exercise – do what you can and build up slowly.

Get into good sleep habits –set bedtimes and waking times according to your own needs.

Make sure you have wind down time and a bedtime routine.

Keep in touch with loved ones. It’s never too late to learn to use technology to keep in

touch. You may need to let others know how long you talk for before you need to take a

break.

Do things that make you feel happy or proud. Again, you may have to limit the amount of

time spent on these things and build up gradually.

Check in with yourself

Mindfulness – it can be easy to rush through life without stopping to notice too much. Paying more attention to the present moment – to your own thoughts and feelings, and to the world around you – can improve your mental wellbeing. It’s best to practice regularly. Here are some examples:

Mindful breathing: sit in a comfortable position and begin paying attention to your breathing. Notice the physical sensation of air filling your lungs, and then slowly leaving. When your mind wanders- which it will, simply notice your thoughts and turn your attention back to breathing.

Body scan: starting with your toes and working your way up to the top of your head, notice the sensations in each part of your body. For example, notice the feeling of clothing resting on your legs, tension in your muscles, or cool air on your face. This exercise can help bring you back to the present moment if you feel overwhelmed.

Scan your senses: make a conscious effort to focus on your senses scanning through five

things you can see, four things you can hear, three things you can feel, two things you can

smell, one thing you can taste.

You can find lots of helpful mindfulness resources such as apps, downloads or guided exercises

on the internet.

Other NHS approved apps can be discovered here:

https://www.nhs.uk/apps-library

Allow others to help you, friends, family, community and professionals.

The community neuro rehab team has collated resources for wellbeing:

https://www.shropscommunityhealth.nhs.uk/cnrt scroll down to Covid-19-related

documents.

When you may need professional help

Low mood and depression

Ask yourself the following:

In the last two weeks, have you felt down, depressed or hopeless or gained little interest or pleasure from doing things on more than half the days?

Has this caused problems with your day-to-day functioning?

If the answer is yes then you may be experiencing depression. Consider seeking professional help, e.g. from your GP or local psychological therapy services.

If you have persistent feelings of hopelessness or thoughts of death/ ending your own life then you should seek professional support as soon as possible.

Anxiety

Anxiety can have a wide range of physical and mental symptoms.

Ask yourself the following:

In the last two weeks, have you felt nervous, anxious or on edge or been unable to stop or control worrying for more than half the days?

If the answer is yes then you may be experiencing anxiety. Consider seeking professional help, e.g. from your GP or local psychological therapy services.

Some people have specific forms of anxiety such as panic attacks. Panic attacks in themselves are not dangerous, though they can feel frightening. During a panic attack we release a hormone that lingers for a while in our bodies before subsiding and it’s this hormone that causes a quickened heartbeat, sweaty palms, racing thoughts etc. as our bodies prepare us to quickly respond to threat. It can help to remember that these sensations will pass if you don’t fight with them or think something terrible is going to happen but if you remain on high alert, the panic attack may go on longer. You may wish to seek professional support with panic attacks.

Post-Trauma Responses

There has been a lot of information in the media about post-traumatic stress disorder (PTSD), which is a severe and persistent reaction to psychological trauma. Some people do not experience symptoms straight away but may do so after a delay. Many people will experience less severe responses that still require professional support whilst others may even go through a period of positive growth following a traumatic event. A period of reflection is a natural response and can be used to determine how you move forwards with your life.

Below are signs that you may benefit from seeking professional support, e.g. from your GP or local

psychological therapies services.

Repeated, involuntary and intrusive distressing memories of the event

Fear, helplessness or horror

Nightmares along the same themes as the event

Distressing thoughts or images that feel like you are back in the traumatic event and you

may react on that basis

Intense or prolonged distress when reminded of the event

Physical signs of anxiety such as trembling or feeling sick when reminded of the event

Actively avoiding any memories of the event or anything that reminds you of the event.

Getting Help

Don’t be shy to ask for help. Below are listed various sources of help locally and nationally. Your G.P. can help you so just book an appointment. Be clear if you think you may need to speak to someone urgently about your mental health.

You can seek help from local psychological therapies services without a referral from a professional:

TELFORD Primary Care Wellbeing Service Telephone: 01952 457 415 Email: wellbeing.telford@sssft.nhs.uk Online: https://telfordwellbeingservice.mpft.nhs.uk/ SHROPSHIRE IAPT Telephone: 0300 123 6020 Email: iaptshropshire@nhs.net Online: https://shropshireiapt.mpft.nhs.uk/

NHS Every Mind Matters website: www.nhs.uk/oneyou/every-mind-matters

Useful Community Links

Age UK Shrewsbury – 01743 233123 Telford – 01952 2018030 Ludlow – 01584 878046

Offering free shopping service to those who are isolated or have no family support. Open to new

referrals.

Mind Telford - 0300 124 0365 Shrewsbury - 01743 368647

Access Service for adult mental health

Royal Voluntary Service

Shrewsbury, Ludlow, Oswestry. 01743 240271

Telford: 01952 382030

Paid support with shopping, prescriptions, dog walking. There is a travel fee, payable by cash or

cheque.

Shropshire Council – First Point of Contact ‘FPOC’

Community directory for Shropshire Council residents.

0345 678 9044

Telford & Wrekin Council 01952 387780 Community directory for Telford & Wrekin Council residents.

If you require support accessing hot meals at home, you can either contact Adult Social services or go via Government website: www.gov.uk/meals-home

https://ww.facebook.com/foodshareproject/ can provide support with food provision if you have been furloughed

Volunteer shopping cards:

https://cards.asda.com/volunteer https://sainsburysgiftcard.co.uk/ https://morrisons.cashstar.com/store/recipient?locale=en-gb https://www.tescogiftcards.com/