There’s a lot going on the NHS locally at the moment so this update is longer than usual – please enjoy!
I am pleased to tell you that we are now seeing very few admissions to our wards of patients who might have Covid-19 and the number of confirmed cases is down to single figures. We continue to celebrate when people like Muthucumaru Yasocumaron are discharged home. He told us the staff who cared for him for 98 days at Queen’s Hospital were “like angels sent from heaven to help me”. Muthucumaru’s story of recovery is one of many we have been privileged to hear as we’ve responded to the pandemic.
Third phase of the NHS’s response to Covid-19
While there is understandable concern about the prevalence of the virus in the community, inpatient numbers have fallen nationally. NHS England has written to health leaders outlining what it describes as the third phase of our response to Covid-19. The letter’s authors write about a ‘window of opportunity’ between now and winter and call for an acceleration of the return to near-normal levels of non-Covid health services, making full use of the capacity available.
The letter sets out some demanding and ambitious targets. Our focus in the coming months is on restoring our elective (planned) care; expanding our critical care so we can respond properly if there is a second spike in Covid-19; and ensuring we can cope with the increase in admissions that will occur once winter approaches.
The challenges these priorities present are significant. As I’ve written before, we have a segmented workforce because we’ve created ‘green’ and ‘yellow’ zones to keep our patients and our staff safe. We also have a workforce that is tired; we are encouraging colleagues to take leave and to rest and recover.
We are fortunate that we are not doing this on our own. Rather, we are working closely in north east London with Barts Heath and the Homerton to co-ordinate the care we provide.
Planned surgery at King George Hospital (KGH)
One of the difficulties we’re encountering is people’s unwillingness to come into hospital for treatment. An impediment has been the length of time a patient was expected to shield before and after surgery. So, it’s good news that the latest NICE guidance is now offering a more flexible approach when it comes to such shielding.
People have also been concerned about being admitted to hospitals where the virus has been so prevalent. Ray Potter’s message of reassurance is particularly welcome. After undergoing complex surgery in our Covid-protected ‘green zone’ at KGH, Ray was keen to tell potentially nervous patients that they would be “well looked after” and there are “lots of checks in place to keep you safe”.
It’s an inescapable fact that our waiting lists will increase in size before we succeed in reducing them. Our limited capacity is being used for those deemed to be priority patients. We are also focusing our attention on the patients who have been waiting a very long time for their treatment.
In my July Board report, which I shared with you last week, I wrote about the priority we have been placing on conducting risk assessments for our at-risk staff, including our BAME colleagues. I’m delighted that 96% of our BAME staff have completed their risk assessments (at time of writing).
The information we’ve gathered during this exercise will help us to understand where there might be areas of potential risk for colleagues and to support them as we restart our services and deploy individuals to the different coloured zones. We’ve now been asked to undertake risk assessments for all our staff.
BHR Health and Social Care Academy
The recruitment and retention of our staff will have to underpin all of the work I’ve been describing. With our partners in Barking and Dagenham, Havering and Redbridge (BHR) we’re creating a BHR Health and Social Care Academy to train our workforce and to offer interesting careers to those who live in the three boroughs.
We have a steering group; we’re establishing what the ambitions are of those involved and what we can do together; and we’ve appointed a Programme Manager. Narinder Chahal has extensive NHS experience and has worked on a number of projects across London. She’s keen to hear from people who would like to share their ideas on how the Academy should work.
The past few months has generated so much for us all to reflect on, not least the kindness many people have shown. Otis Griffith’s love for the NHS (in the form of a metal sculpture) is now on display at KGH.
Our Lead Chaplain, Phil Wright exploited a brief lull in his busy workload to write about his personal experience of living and caring through Covid-19. The honesty of his account makes it a very compelling read.
Thank you for reading my weekly updates and I trust you continue to find them helpful. I hope you have an enjoyable and productive week.
From Barts Health:
Webinar: The future of outpatient services at Barts Health NHS Trust, co-hosted by Healthwatch network
Barts Health NHS Trust is undertaking a major transformation of outpatient services across its five hospitals: Newham, Mile End, St Bartholomew’s, Whipps Cross and The Royal London.
A webinar on Thursday 13 August at 3pm will be the first in a series of webinars, where you can hear about the plans and have your say.
Further information, including how to register and submit questions in advance of the meeting are available on our website.
From East London Health and Care Partnership:
Personal protective equipment (PPE) update
Preparations are underway to make sure we have enough PPE for winter or a potential second Covid-19 surge. The NEL PPE emergency hub has a dedicated team in place for the next 12 months at a minimum, to provide additional assurance on making sure organisations have the PPE they need to keep their staff safe. This hub is in place as an emergency route as business as usual supply chains have returned to normal, which means we are even better placed for winter and a second surge. We are also looking at how we can increase the quantities available to order for organisations from the end of August onwards, to help prepare for the additional PPE required for administering the flu jab.
The Government’s obesity strategy released this week, is particularly timely, given that in the last few months we have seen that being overweight or living with obesity puts you at risk of dying from Covid-19. We are looking at the strategy and how we can work together across north east London to implement it. The strategy recognises that GPs and health care professionals are often the first port of call when people need health advice and support and will bringing forward a programme with incentives for GPs and referral pathways into weight management services in every local health care system. Read the strategy here: www.gov.uk/government/publications/tackling-obesity-government-strategy/tackling-obesity-empowering-adults-and-children-to-live-healthier-lives
In support of the strategy, the Department of Health and Social Care and Public Health England have launched the Better Health campaign, which highlights how our current health could determine our ability to fight diseases such as Covid-19, as well as cancer and heart disease and encourage people to ‘start their journey to better health’. Find out more here: www.nhs.uk/better-health/
Travelling abroad this summer?
We are receiving queries about people travelling abroad who want a certificate to prove they do not have Covid-19, as some countries may require proof of recent COVID-19 testing for entry. Our advice is to check this Foreign and Commonwealth Office webpage: www.gov.uk/foreign-travel-advice (see the summary, health and entry requirements sections).
A number of commercial Covid-19 tests are available. Testing for international travel purposes is only available as a private service with private providers e.g. some private GP services, travel clinics or other private testing services. There would be a charge made for the test and any paperwork issued.
How you can help us
During this time of incredible pressure on the NHS, you can help us by:
Staying alert to stay safe, by staying home if you can, and taking precautions when out and about, such as wearing a mask if appropriate. You can find all the latest information, guidance and support here: www.gov.uk/coronavirus
Sharing our survey looking for feedback on people’s experiences of accessing health services during lockdown: www.surveymonkey.co.uk/r/PRN8G52 – it closes on Sunday, so please share now.
Sharing the details of a public event on Thursday 13 August about how outpatient services are changing across Barts Health NHS Trust. Co-hosted by Healthwatch, this is the first in a series of webinars for patients and communities to hear about how hospital outpatient services have changed in response to the pandemic and provide their feedback on future plans.Details here: www.bartshealth.nhs.uk/news/public-event-find-out-about-changes-to-outpatient-services-8744
If you have any queries about our response to the COVID-19 pandemic that you would like covered in future updates, please email firstname.lastname@example.org
From London Ambulance Service (LAS):
Prime Minister thanks LAS for “brilliant response” to COVID-19
This July, the Prime Minister Boris Johnson thanked everyone at LAS for their “brilliant response” to COVID-19. Mr Johnson visited LAS headquarters in Waterloo and met call handlers and ambulance crews – as well as teams working behind the scenes – who have been at the forefront of the capital’s response to the national emergency.
During his visit, the Prime Minister announced a consultation has been launched into increasing the maximum sentence for assaults on emergency workers from 12 months to two years.
With our staff and volunteers seeing more than 130 physical assaults in the last three months alone, we welcome the opportunity to contribute to the consultation as we aim to ensure our staff and volunteers have the ability to undertake their duties free from abuse and violence.
Independent review supports bigger role for patients in shaping LAS services
An independent review has recognised the ‘deep commitment’ of LAS to improving services by working with patients and members of the public.
Mike Cooke, the Independent Chair of North London Integrated Care System, was asked to undertake his inspection to support delivery of a new Public and Patients Council and to inform a far-reaching patient and public engagement strategy to be unveiled this year.
Mr Cooke found the Trust leadership was ‘deeply committed’ to public and patient involvement and backed a new approach to reflect the expansion of services offered by LAS and the greater diversity of London’s population.
We’re moving from paper records to electronic Patient Care Records
As part of the LAS’s digital transformation strategy we will be replacing the paper-based patient record form with an electronic patient care record (ePCR) across the LAS.
The move from our current paper-based patient record form to ePCR will reduce this waste and is a shift in the Trust’s ability to triage and treat patients. The chosen product, Cleric ePCR, has been tried and tested by a number of Trusts across the UK to share information electronically
ePCR will hugely enhance our ability to integrate our patient care with the wider NHS and care system in London – enabling our partners to have greater visibility of our clinical service and the experience of the collective patient population.
We have started our engagement process and aim to keep all stakeholders updated on this exciting change for the Trust. We will be providing regular updates on our progress during the next few months. For questions or more information: Londamb.ePCRfeedback@nhs.net
We’ve been shortlisted for the HSJ Patient Safety Awards
This month LAS has been shortlisted for the Health Service Journal Patient Safety Awards in five categories. These are:
* Deteriorating Patients and Rapid Response Systems Award
* Mental Health Initiative of the Year Award
* Maternity and Midwifery services Initiative Award
* Urgent and Trauma Care Safety Initiative Award
* End of Life Care Award
We have been shortlisted for a wide range of initiatives across the Trust, including the launch of our Mental Health Joint Response Car, our Specialist Falls Service, our End of Life Care Coordinator Network with Macmillan among many other initiatives.
The winners of the awards will be announced in November 2020.
About London Ambulance Service
London Ambulance Service answers more 999 and 111 calls than any other ambulance service in the UK. Our crews go to more than 3000 emergencies a day and handle over two million 999 calls a year.
Our 24-hour 111 integrated urgent care services in north east and south east London answer more than 1.2million calls a year.
We are the only NHS provider trust to serve the whole of London and the nine million people who live in, work in or visit the city. We cover an area of 620sq miles and our average response time to the most serious emergencies is less than seven minutes.
We have 8000 people who work or volunteer for us and together we are striving to ensure patients receive the right response, in the right place, at the right time.
We work closely with our NHS partners including NHS England, our commissioners, hospitals, specialist trusts and the five sustainability and transformation partnerships (STPs) and Integrated Care Systems (ICS). We play a leading role in integrating access to emergency and urgent care in the capital.
Our collaboration with the Metropolitan Police Service, London Fire Brigade, London’s Air Ambulance and London’s Resilience Forums means we are ready and prepared to respond to major incidents; and ensure we keep Londoners safe.
By integrating our 999 and 111 services we are able to treat more patients over the phone; in their home; or refer them to appropriate care in their own community. This is key in achieving our strategic ambition of reducing the number of unnecessary trips to hospital; and should mean 122,000 fewer patients a year being taken to emergency departments.
Author: Councillor Gerry O'Sullivan
Gerry is a Ward Councillor for St. Andrews & Hornchurch Resident's Association Executive member.