What should I do if I have concerns about my health?

Your GP is your first port of call and will assess your needs and refer you to the right specialist care.

Some local residents have complained about the Grenfell cough. What services are available for them?

We would urge all local residents who have concerns about their health to contact their GP. They have extended appointments so they have time to talk things through and you can also have the Enhanced Health Check which will look at your current health. Residents can be referred onto specialist services as required such as the respiratory.

What is the difference between a normal NHS health check and an Enhanced Health Check?

The Enhanced Health Checks that we have introduced include a respiratory examination and mental health screening for trauma, offering a more comprehensive assessment than a standard NHS health check. The check is designed as an initial assessment to detect the early signs of health problems or any underlying health conditions. If a cause for concern is identified, people are referred on to the appropriate specialist service. The check is different to screening and does not offer toxicity testing as this has not been recommended by our scientific advisers. The three key components for adults include:

Find out more about the Enhanced Health Check for adults and children.

We know it is not the 'screening' or biometric testing that some people are calling for, but the advice we are getting (from the Government led Multi Agency Partnership) is that the Enhanced Health Checks are the right thing to do at this stage. If that changes we will change our services as appropriate.

Who provides an Enhanced Health Check?

The service is provided by the majority of the North Kensington GPs, with additional capacity offered by the community provider 'Enhance' (Thrive Tribe). If your GP practice does not provide an Enhanced Health Check they will refer you to another local GP practice that does.

How many people have had an Enhanced Health Check and what have you found?

So far over 1000 Enhanced Health Checks have been delivered. They have been very successful in identifying conditions such as diabetes, supporting people in stopping smoking and with weight management. A smaller number of people have been identified as needing further assessment and have been referred onto the fast track Respiratory Service.

Why are you not testing for cancer?

We understand some people are worried they may get cancer as a result of the fire. There is no single test for cancer that we could use to identify all forms of cancer and we are being advised by health experts that this would not be effective. We are advising patients that If you are worried to speak to their GP. We would also encourage people to make use of the national screening programmes for breast, cervical and bowel cancer detection if they are eligible. Speak to your GP for more information.

What issues have you picked up in the community?

We acknowledge that there is some variability in service delivery from general practices and inconsistent messaging from GPs and Enhance as to the need for spirometry which is part of the enhanced health check. We also know that not enough people understand what services they can get and sometimes that includes our own NHS staff. We are looking at what we need to do now in order to sort that out as a matter of urgency.

What do I do if I feel I am feeling down or struggling?

The Grenfell Health and Wellbeing service is a free and confidential service for children, adults and families affected by Grenfell. We know that people are experiencing a broad range of difficulties following that night. For some, it has triggered distressing thoughts, memories and nightmares. You may be struggling to sleep, feeling anxious, angry or low in mood. Some people may experience persistent and traumatic feelings of grief, or adjusting to life and changes following the fire.

We offer tailored support to give you the help you want, at the pace you need it. You can telephone us on: 020 8962 4393 or visit www.grenfellwellbeing.com and complete a referral form. The children's arm of the service also works closely with schools and families to support children and young people in need of emotional support.

What do I do if you need urgent mental health support?

If you or someone you know needs urgent emotional support or help out of hours you can contact the NHS 24 hours a day, call 0800 0234 650 or email cnw-tr.SPA@nhs.net. The service is confidential and you do not have to give your personal information. The person who answers the phone will make sure you get the right support from the right service.

You can also call the Samaritans on 116 123. This is a free, confidential 24 hour service.

What are the potential long term health risks for local residents following the fire?

Residents who were not directly impacted by the fire, who didn't suffer significant smoke inhalation and are generally fit and well, will have minimal long-term health problems resulting from the fire. There is no evidence of any impact on fertility from temporary exposure either.

Have GPs been advised to expect enquiries from Grenfell victims with breathing/chest problems?

The CCG is working closely with local GP practices to ensure they have capacity to see and respond to patients who are attending appointments with breathing/chest problems. Our practices that are based within the local area are aware that there may be an increase in respiratory queries and these patients are to be prioritised appropriately.

What advice, information or training have GPs received about the respiratory difficulties people are experiencing since the fire?

GPs are providing a front-line service for respiratory problems for all residents. The CCG is working closely with the community respiratory service provider, Imperial Healthcare Trust. The Trust are providing advice and guidance for GPs to help them support residents with respiratory conditions.

The CCG has been working with Imperial Healthcare Trust, to put in place a 'fast track' referral process for patients to be seen within 14 days in the community respiratory service. Some patients may need a chest x-ray prior to being seen which can be accessed at St Charles Urgent Care Centre.

For further information about the ‘fast track’ community respiratory service provision, speak to your GP.

Have GPs been asked if there has been an increase in people with chest problems?

The CCG has contacted and supported all practices in the surrounding area to ascertain if there has been a significant increase in the number of residents reporting respiratory/breathing problems. The CCG can confirm that our practices have not experienced an increase in residents presenting with respiratory conditions, however the CCG will continue to monitor this closely.

The CCG has provided all practices with information and details on how to 'fast track' patients to the community respiratory service.

Are there plans for long term studies on the respiratory health of the local population, especially children, young people and those susceptible to lung problems?

Public Health England has been closely assessing the impact of the Grenfell Tower fire on air quality during and after the fire, and there has been no detectable deterioration in air quality. Currently local GP practices have not reported an increase in patients with respiratory conditions. We consider there to be no wider health risk to the local population relating to air quality, and therefore, there is no plan for long term studies on the respiratory health of the local population.

Are there any health tests local residents should have if they are concerned about smoke inhalation or toxicity?

People who were treated in hospital for smoke inhalation will have follow-on care from and any appropriate tests carried out by hospital doctors. People who inhaled smoke but were not unwell enough to require hospital admission are very unlikely to have any long term health risks.

Are there any symptoms local residents should be aware of relating to smoke inhalation or toxicity?

Smoke from any fire is toxic, and chemicals that can be present in smoke include carbon monoxide, hydrogen cyanide, hydrogen chloride and hydrogen bromide. However, chemicals produced by the Grenfell Tower fire will not be present now as the fire has been extinguished, and the public is no longer at risk.

The amounts of toxic substances will vary with the specific materials involved in a fire, its temperature and the amount of oxygen present. Smoke inhalation may lead to toxins being absorbed into the body, including carbon monoxide and hydrogen cyanide. These chemicals would only have stayed in the body for a short period of time and will no longer be present. Residents who were not directly impacted by fire are unlikely to have been exposed to elevated levels of toxins within the smoke.

What should I do if I am concerned about any respiratory symptoms following the fire; for instance if my asthma/COPD is worsening?

Respiratory illnesses can be caused by a number of reasons other than exposure to fire. Public Health England has confirmed that the air quality around Grenfell Tower is safe for residents. The CCG is aware that residents are still concerned about respiratory conditions so health workers based within the community centres are directing people to their GP for assessment, treatment and advice. Those residents who require respiratory screening/on-going treatment can be 'fast tracked' by GP referral into our community respiratory service. These patients will be seen within 14 days of referral.

The CCG launched a website for residents to access health information and this includes links to online symptom management support for various health complaints including respiratory issues.

Advice for residents who feel they have respiratory issues is to call either NHS 111 for urgent advice or 999 for an emergency response.

The statement from Public Health confirms that the air quality is safe now. But how safe was the air when the building was burning? What are the effects for me if I stood watching the fire for 16 hours?

Air quality in North Kensington on the day of the fire remained within normal limits. People who observed the fire but did not have any direct smoke inhalation will have had minimal risk to their physical health.

What is a spirometry test?

Spirometry is a simple test used to help diagnose and monitor certain lung conditions by measuring how much air you can breathe out in one forced breath. It's carried out using a device called a spirometer, which is a small machine attached by a cable to a mouthpiece.

Some of the conditions that can be picked up and monitored using spirometry include:

- Asthma

- Chronic obstructive pulmonary disease (COPD)

- Cystic/Pulmonary fibrosis

What will the £50m investment in the NHS be used for?

The £50m investment over the next 5 years will be used to fund new services introduced since the fire and to create new services which reflect what local people tell us they want. It will allow us to shape specific physical and mental health services beyond the usual offer from the NHS to respond to the unique needs of a community affected the Grenfell Tower Fire, such as extended appointment time, mental health screening and physical health monitoring. It will also allow us to identify and support emerging or new health needs and develop initiatives to address these, including any services that may be required as a result of the soil toxicity assessment currently being carried out.