From BHRUT A window of opportunity. The coming months have been referred to as a “window of opportunity”, a chance to treat more non-Covid patients before we have to deal with winter and a possible second surge in the virus. It’s an opportunity we’re seizing. We have only one Covid ward and just a handful of patients who have tested positive. We continue to be heartened by the stories of recovery and touched when patients and relatives take the time to praise our care.We are focusing on utilising our capacity as best we can, so we can treat more people. At King George Hospital (KGH) – where our ‘green’ and “yellow’ Covid zones are now well-established – we have seven theatres in operation, and we are looking at increasing our sessions in the evenings and at weekends. We need to develop our ‘green zones’ at Queen’s Hospital so we can do more surgery there.As we seek to maximise what we do – within the confines of the infection prevention and control guidelines that we are adhering to – we must ensure that we do not make existing inequalities worse. This is something we need to monitor across north east London with our colleagues at Barts Health and the Homerton.We are aware that many people are still not willing to come to hospital for their operation and we need to see if there is a pattern to this. We continue to do all we can to reassure people about the safety of the environments we have created. A study in June showed that none of the 260 people who had endoscopy procedures with us developed Covid as a result of their appointments.Fulfilling careers at our Trust
Our workforce is crucial to all that we do. We need to continue to look after our staff and develop them.
We hope these articles and broadcasts inspire readers, listeners and our staff – both existing ones and those we may recruit in the future. My colleague, Kenye Karemo, is doing a lot of work on developing careers at the Trust. She’s written about some of it in a newsletter that I would recommend you read. It captures the stories of our staff and the life-changing experiences they’ve been through.
I am particularly proud of the fact that, at the height of the pandemic – when the future of their training was in doubt – we recruited more than 100 student nurses and gave them paid roles across our Trust.
One of the many painful consequences of Covid-19 has been the restrictions on visiting we have had to enforce. They are in place to keep patients and staff safe and we keep them under review.
Their imposition has meant that teams have had to redouble their efforts to keep relatives informed. The restrictions have had a particular impact on our neonatal intensive care unit where parents’ access has been limited and other family members haven’t been able to attend.
As a regular reader of this newsletter, you will have sensed the pride I feel working alongside so many amazing individuals. As well as keeping you up to date with how we are living with Covid, I have also used this weekly message as a way of sharing our stories of achievements.
“In Conversation With” is one of the channels we use to learn more about colleagues. The most recent instalment features Maria Benedetti. She is our Lead Midwife for Multi-Ethnic Empowerment and she provides support for our BAME pregnant women.
I hope you have a productive week and survive both the intense heat and the storms that are forecast to follow.
Tony Chambers, Chief Executive
From NEL Primary Care Commissioning Alliance
Third phase of Covid-19 response
As of 1 August, the NHS Emergency planning and preparedness incident level has moved from Level 4 (national command, control and coordination) to Level 3 (regional command, control and coordination with national oversight, as this remains an incident of international concern.
What this means for the NHS has been set out in a letter from NHS England Chief Executive, Sir Simon Stevens, and Chief Operating Officer, Amanda Pritchard. The letter sets out NHS priorities for this third phase:
Accelerating the return to near-normal levels of non-Covid-19 health services, making full use of the capacity available in the ‘window of opportunity’ between now and winter.
Preparation for winter demand pressures, alongside continuing vigilance in the light of further probable Covid-19 spikes locally and possibly nationally.
Doing the above in a way that takes account of lessons learned during the first Covid-19 peak; locks in beneficial changes; and explicitly tackles fundamental challenges including: support for staff, and action on inequalities and prevention.
There are some demanding and ambitious targets such as:
The restoration of full operation of all cancer services and the maximum elective activity possible between now and winter.
General practice, community and optometry services should restore activity to usual levels where clinically appropriate, and reach out proactively to clinically vulnerable patients and those whose care may have been delayed.
Rapid progress in addressing the backlog of childhood immunisations and cervical screening.
All GP practices must offer face-to-face appointments.
Transforming commissioning in NEL
This week we shared our vision for how we will work in partnership across north east London to provide the best health and care possible for our local populations. The future of health and care for the people of North east London’ sets out our core overarching NEL vision as we continue to develop our NEL Integrated Care System and transform commissioning, ultimately establishing one single CCG for north east London by April 2021. We will be engaging with our GP members and stakeholders and will provide regular updates in this update, but if you have any questions or would like to provide any feedback please email email@example.com
All our partners across the health and care system are working tirelessly to make the changes necessary to provide the full range of services to all patients during the Covid-19 emergency. Working within the framework set out by NHSE/I in Journey to a New Health and Care System, available here: www.eastlondonhcp.nhs.uk/downloads/ourplans/Coronavirus/Journey%20to%20a%20New%20Health%20and%20Care%20System.pdf
We are involving patients, patient representatives and stakeholders to understand how changes to services have affected people. We are also investigating what further changes we now need to make to ensure all our buildings and procedures are safe, and how we can provide confidence in our processes to anyone who has a need for health or care services. Unfortunately there are patients with potentially serious conditions who are reticent about coming forward to talk to their GP.
We recently received a report on the dialogue with Londoners which explored hopes, fears, concerns and expectations in relation to the measures being put in place in response to the COVID-19 pandemic in the NHS. You can find out more and read it here: www.onelondon.online/
There are dozens of other surveys which have been carried out across north east London and we are in the process of commissioning an analysis to ensure we understand the full picture. If you have conducted research into the affects of Covid-19 on health and care systems, please do send them to firstname.lastname@example.org
Wearing face masks
From Saturday 8 August the places where you will have to wear a face covering will be expanded to include museums, galleries, places of worship, libraries, and community centres, among other locations. Face coverings are also needed in NHS settings, including hospitals and primary or community care settings, such as GP surgeries.
Exemptions from wearing face masks
Those who have an age, health or disability reason for not wearing a face covering should not be routinely asked to give any written evidence of this. No person needs to seek advice or request a letter from a GP or medical professional about their reason for not wearing a face covering and GPs do not provide exemptions.
From 1 August, shielding advice to those who have been identified as clinically extremely vulnerable has been relaxed and the national shielding programme is being paused. The Shielded Patient List (SPL) will still be maintained while the shielding programme is paused, as the government may advise people to shield again if there is an increase in transmission of coronavirus in the community. Clinicians will continue to identify people who may be considered clinically extremely vulnerable based on the existing criteria and add them to the SPL.
Measures are being put in place to support safe service restoration and provide environments where the risk of infection is managed for all patients. We recognise that people who have been shielding may be particularly anxious about attending health settings, and we are taking this into account when planning care and encouraging people to visit NHS sites.