Monthly archives: March 2020

COVID-19 bulletin: Saturday 21 March

The Trust is now publishing a daily bulletin. This will take all guidance and information and tell you which changes we are implementing when and how. Please use this bulletin and daily cascade arrangements within clinical groups to guide local action. Remember KINDNESS is our watchword in implementing these changes.

1. Social Distancing – Preventing the spread of Covid-19

Social distancing is one of the many measures you should take to help prevent the transmission of Coronavirus (Covid-19). Along with ensuring you follow guidance on wearing the appropriate PPE to washing your hands thoroughly and regularly, social distancing helps you manage social interactions which may inadvertently put you at risk.

Meetings in confined rooms should be avoided and moved to phone calls, conference calls or webex. Where face to face meetings are necessary, look to hold these in rooms where you can spread out with a reasonable distance between colleagues.
Make use of technology where possible. Alongside emails, all colleagues have access to Whatsapp Web which allows you to instant message colleagues from desktops, laptops and mobile phones.
If you are not sure of the phone number for a colleague, either dial 0 from a Trust landline or 4000 from a Trust mobile phone and use IVOR, our automated phone service.
Avoid gathering in close proximity in communal areas, respect the personal space of those around you.
Don’t shake hands with visitors or colleagues, a respectful nod, bow or elbow bump is sufficient.

If you have any queries about tech you can use to work remotely, you can find further guidance in the attached briefing or contact the IT helpdesk on 0121 507 4050

2. Protecting yourself and your families whilst working on the front-line

If you are cohabiting with friends or family and you are concerned that you may be at risk of exposure to the Coronavirus you can arrange to book one of the hotel rooms that the Trust has secured. These rooms are currently being allocated to frontline staff who are looking to safeguard themselves from catching the virus from symptomatic friends or family who they currently live with.

Our Trust is one of the first in the country to offer this resource and we are keen to make it available to our staff. If you feel you need access to one of these rooms you can request one by emailing swbh.hotel-booking@nhs.net detailing your requirements.

To clarify, these hotel rooms are a resource for key staff to use to isolate themselves from symptomatic friends and family, to safeguard their wellbeing and to support their ability to continue providing safe and effective services.

The best ways to protect your friends and family from Coronavirus are to wear appropriate PPE and strictly adhere to the infection control procedures including regular and thorough handwashing.

For further information and advice on self-isolation and absence read the interim guidance available here: Interim Staff Guidance on absence from work (19 March)

3. Deteriorating Patient and Resuscitation: Cardiac Arrest Guidance

The Resuscitation Council UK has updated advice this week stating ‘As a minimum, you require a gown, eye protection, gloves and FFP3 mask / hood before starting chest compressions in patients who are likely to have COVID-19’.

It is reasonable to wear PPE including a surgical mask to recognise cardiac arrest: Feel for a carotid pulse if trained to do so. Do not listen or feel for breathing by placing your ear and cheek close to the patient’s mouth.

Another member of staff wearing PPE with FFP3 will need to take over from you – DO NOT try to swap your mask without full donning technique

DO compression-only CPR
Monitor the patient’s cardiac arrest rhythm as soon as possible
DO NOT do rescue breaths; leave any face mask oxygen in place

The full guidance is available on the Resuscitation Council UK website.

4. Transfer Tubs – Infection control on the go

All Covid-19 designated areas from today (Saturday 21 March) now have ‘Transfer Tubs’ available. These are green tubs of Clinell wipes that should be used when transferring patients who are query or confirmed for Covid-19 between clinical areas.

Colleagues involved in the transfer should ensure that touch points and surfaces that the patient and transfer team comes in to contact with during their journey are suitably wiped down and clean, ready for the next use. This should include touch points in lifts such as call buttons, level buttons and grab rails.

5. Changes to Public Transport

Starting from Monday (23 March) the frequency of train services will be reduced across the country. New timetables will be available online over the weekend from train operating companies. Between Monday (23 March) and Wednesday (25 March) bus operators may reduce the frequency of the services they operate in the West Midlands. New timetables will be available online from Monday. West Midlands Metro services are expected to remain as normal next week but do check for updates in case the situation changes.

Everyone will still be able to get to where they need to go, however, the time at which you normally travel may need to change. We are encouraging everyone to plan ahead at: https://www.networkwestmidlands.com/plan-your-journey/network-overview/

6. Deliveries from NHS Supply Chain

NHS Supply Chain are currently running behind on some orders, that may mean a later delivery than usual. Please bear with the Receipts and Distribution Team at this time.

To ease the demand on the supply chain please focus any supplies orders on medical items and urgent and critical supplies. Stationery orders should not be placed unless they are absolutely necessary.

For more information contact Lisa Southall, NHS Supply Chain & Procurement Supervisor on ext 4938

COVID-19 bulletin: Friday 20 March

1.Information on working from home and on key worker status

A message on working from home has been sent to all colleagues today with a guide on what technology to use. You can read the full message with guidance here. If staff need information to verify that they are a keyworker a letter can be provided. Please contact swbh.hr-advice-for-covid-19@nhs.net

2.Staff meetings – Q&As

Thank you to colleagues for input at the staff meetings. Further meetings will take place on 8^th April. The Q&As from this week’s meetings are attached. If you have a HR related question contact swbh.hr-advice-for-covid-19@nhs.net. For clinical queries contact swbh.covid-queries@nhs.net.

Hotel accommodation can be reserved by contacting swbh.hotel-booking@nhs.net

3.Important infection control information: PLEASE READ AND MAKE SURE YOU KNOW WHAT TO DO

How to send lab samples

You must follow the correct processes to send samples. Please follow this guide for non-respiratory samples (blood, urine, faeces). These can be sent by the pods / air chute system and must be double-bagged. Follow this guide.

Any respiratory sample (combined nose and throat swab, sputum, tracheal aspirate, NDBL) from any patients who are query or confirmed Covid must not use the pods / air chute system. Follow this guide. You must also completed the E28 form for respiratory samples

E28 Form for Respiratory Samples (PDF)

Make sure the waste is correctly disposed by following this pictorial guide – Guide to correct disposal of waste
Reminder of what PPE to wear – Covid-19 Positive and Suspected PPE
NEW – Guide to keeping your workstation clean

Covid-19 Update: Working from home

Dear colleague,

Thank you for your hard work and for helping to tackle the pandemic. As an organisation we are doing what we can to support you as colleagues and employees. If there are things we are not doing that you would like or recommend, let us know. We may not have thought of that, or there may be another reason why your good idea is better timed in a few days or weeks’ time.

Schools close tonight, and we have already confirmed that therefore for some staff who cannot make arrangements, this coming Monday would a day of carer’s leave to do just that. The government has issued guidance this morning on who it considers essential workers, and from that I would reiterate their clear guidance that only one adult in a household must be an NHS worker covered by that guidance in order to trigger access to ongoing educational provision.

We would urge you to work with friends and neighbours to do your best to make arrangements. If you are concerned that living at home may expose your housemates or loved ones to the virus, or that your loved ones may expose you and prevent you working, the Trust has access now to over 150 local hotel rooms which you can use free of charge. Yesterday’s COVID bulletin clarified how to use that resource. The Trust is one of the first in the country to do this, but others will follow suit. This will become part of the NHS wide COVID-19 response, so worth you trying.

An alternative for some employees is to work from home (WFH). This is different to the question of self-isolation. We want to be specific about where WFH is now something we urge you to consider. With over 1800 job titles in our Trust and almost 100 roles, we cannot issue a simple list to you, and so we need to continue to work on trust with your judgment.

If you work administratively, managerially or clinically in a patient facing area, we do not recommend that you work from home.
If you provide ancillary work, for example as a porter or driver, supporting patient care, including transporting samples or stock, we do not recommend that you work from home.
If you work in a corporate / backbone function, for example in finance, governance or HR, it may be possible for you to work from home. We estimate that between 300-500 employees from our 7000 colleagues may be in this position. At this stage we believe all our IT and estate staff do need to be on site.

Before reading on, we need to make it clear that if you are able to work from home there are circumstances where we may ask you to return to site, and that includes circumstances where we ask you to undertake different work in support of the pandemic response. We also should make it clear that we are not telling you to work from home, just making sure your options are clear. We will reassess all home working guidance on April 7th (unless instructed to do so sooner). We also reiterate that working from home does not mean you do not complete mandatory training. Obligations to complete on line mandatory training before 31st March remain.

We cannot provide computer equipment for everyone working from home. Our priority is clinical areas for technology. But we have published on Connect simple guidance for how you can use technology which you can download to run or be part of meetings, and how you can potentially get access to drives and documents. Attached to this email is a brief guide from Martin Sadler which should assist with most immediate queries. From April 1st we expect to have more capacity to provide technology for home working.

If you wish to work from home and are covered by the bullet points above we would ask you to do four things:

Talk to your line manager and discuss this with them. Their agreement is required.
Send an email explaining your job role and the decision you and your manager have made to swbh.wfh@nhs.net .This will help us know who is away but well.
Download the My Connect App onto your phone so you can keep up to date with our guidance and stay in touch with the Trust.
Make sure it is clear on your Trust emails and Trust telephone extension ansa-phone that you are working from home due to Covid.

Finally, I want to make it clear that you are essential to this Trust. Working from home does not mean that you are less important to our fight or our future. The NHS is a team. But as the country moves towards significant restrictions on movement and an expectation of social distancing, we want Trust employees to make decisions ahead of instructions.

Please use this weekend to think through your plans, and then talk to your line manager today or early next week.

Every best wish,

Toby

Chief Executive

Sandwell and West Birmingham NHS Trust

Chief Executive’s Message – Friday 20 March

Last weekend I walked many of our wards and departments listening to people’s feelings and fears about COVID-19. This week amid the press conferences, we had a huge amount to do to keep getting ready for the marathon that is our response in Ladywood, Sandwell and Perry Barr to this pandemic. I met more than 150 colleagues in staff meetings on Wednesday and heard from dozens more, directly. I want to say both thank you to you all for your intense hard work and for your kindness, but also to reflect how important the feedback we have had this week on what’s working and what is not working in the planning of the response. I know that some colleagues in primary and community teams feels like the poor relation of this situation and next week myself and others are doing some time shadowing work with some of you to make absolutely sure we can see this situation through your lens. I know too how challenging this situation is for students and those in training, whose plans have been turned upside down. Whether you are an apprentice with us or enrolled through a university we will honour our commitment to you.

This week many of those same community teams were the folk who wholly relocated our Leasowes wards to Rowley Regis to create an end of life care centre in our Trust for patients unable to be in side rooms on our acute sites. Our Star of the Week this week is Neil Davies, Community Transport Driver who worked exceptionally hard to move the patients from Leasowes. Neil reassured anxious patients and kept the team positive, enabling the transfers to take place within the day.

PPE is the understandable focus for many in our teams. We have stores now on D18 at City, on Bryan Knight suite at Sandwell, and at Rowley, Leasowes and community bases for the community teams. It is clear we are not applying every outcome from a historic fit test. It is clear we are following national guidance that balances best case and supply. Having stopped day surgery today and with a big order delivered yesterday we are better placed than before. We have issued written guidance and hand delivered it to many ancillary teams. So now is the time to be careful about what is worn where and to challenge one another when someone’s use is outside our norms. To be very explicit, out of hours decisions on what PPE is released are solely the preserve of our CNP team. Please respect the difficult decisions that they may have to make – they have my full support in making those decisions. When we disagree on such decisions, let’s do so with civility and calmness. No matter your perceived seniority we will address inappropriate behaviour in this regard.

The focus next week will be on getting our temporary redeployment training ready. For many people we will be rolling out the respiratory care refresher training announced by NHS England midweek. Already ITU colleagues are putting in place extended training for others in surgery who will be supporting the expansion of our units, including into theatre recovery. Last week we ceased all less urgent elective inpatient surgery and today we did likewise with day case surgery. I do not underestimate the misery this will cause for patients, including colleagues on our own staff. We have only slightly pre-empted the national position and continue to look to see what can be done to expedite operations vis the private sector under the NHS. I want to reassure colleagues working in outpatient areas that, whilst we will, in all probability, ask you to work in the near future in some inpatient functions, you will be provided with training, mentorship and support. No one is to be asked to work beyond their credible competence. Some people will be asked to resuscitate skills they have set aside or develop, with our support, new skills. Thank you to many non clinical staff who have volunteered to do what they can, and even if earlier today we suggested you could work from home for a few weeks we will be working to understand and support you to come back to site later in April to help with the effort to surmount the first peak of the virus.

As that last sentence implies, we cannot be certain that flattening the curve means just one surge. We must approach this global issue on the basis that, for perhaps the first time in a hundred years, we may see multiple peaks over a period of time, between six and eighteen months, and we need to find a route to tackling this as best we can. No amount of upbeat camaraderie alters the fact that this is a crisis on an epic scale. On the other hand socialised medicine, our NHS, is uniquely well prepared to address this societal challenge, which is no respecter of wealth, place, or background. And in an ageing society, perhaps this is the wake up call that we need to think through how best we support older adults in our community and find a properly integrated model that links supported housing, day care, nursing and care homes, and acute services.

Meeting the challenge also requires a different compact between employees and the organisation. Again let’s use that to best advantage. The model is one of trust. If you self isolate, certainly the first time you do, we will not require documentation or proof. We will work with each individual to help you, just as we hope that many of you move now to hotels at the public expense where being at home risks harming your loved ones, or impairing your ability to work. We are absolutely maintaining our wellbeing activities, yoga and beyond, and providing showers, food and other things. There is not an absolute annual leave ban. Of course some leave will be cancelled in April, May and June. You will not lose leave, or money, nor be compelled to take leave. But this is a long haul project, and so we have to balance staffing levels for now against having you fit to work this summer and autumn. There will not be ‘carte blanche’ on agency use. Not because money is a constraint, but because we need experienced teams. So we are investing in our bank rates in April, paying more for people who do a certain number of shifts. If that works (and let’s be clear increasing the bank pay rate this winter did not work) we will continue and expand it, as we seek continuity in teams and experience on the squad. Agency remains a premium of wasted money on workers who often are not able to do the full range of tasks our jobs require!

Attached to today’s message are some Questions and Answers from this Wednesday’s first COVID-19 CEO staff briefing meetings. More are planned for 8 April. It was good to see more than 150 colleagues attend, many on behalf of their teams. It was clear that our plans were still being made sense of locally and that some areas of the Trust, especially teams like porters, catering and PTS had been left in the dark about key details. That was not the intention. But it is a failure, and one I own completely. We will improve our model for communication beyond email. You can help by registering to use myConnect our mobile app (search SWBH myConnect on Google Play or the Apple App Store). In addition to content including videos, that app allows us to push guidance to you, prompting you to consider amends to that guidance as it evolves. I was asked in all sessions whether we would be compelling colleagues to act in certain ways. The answer is nuanced. Part time colleagues stay part time, but we’d love you to do overtime. Those leaving us cannot be made to stay, but please do. On the other hand, with PPE in line with our policy, and training, we can insist that you treat infected and query infected patients. There is no self isolation because of the state of public transport. We are trying to balance tackling individual anxiety with making sure we can rise to the challenge the country demands of us. I remember many years ago asking my Nana, what did you do in the war? No really, that is the scale of what we are facing: Your kids and grandkids, mine too, will ask. Let’s do what we can to live up to their belief in our basic decency, kindness, and bravery. Thanks again for facing this. I know it is not easy. I am proud of the teams that are the heartbeat our organisation, including our silver squad – led by Liam, Paula, and David, who are trying to manage COVID-19, and make sure in 2021 we are not still talking about this in the present tense.

Remember we share COVID-19 briefings now in two ways: Our daily e-bulletin, and our clinical queries briefing from David Carruthers and Tarun Saluja. Both are visible to all on Connect or myConnect.

Heartbeat: Outstanding achievement for Broadway Health Centre

Collaboration, co-operation and co-ordination, three key ingredients that thanks to the support of clinicians from our Trust have recently helped Broadway Health Centre in Birmingham achieve a glowing CQC report that highlights their care as ‘Outstanding’.

Broadway Health Centre was inspected by the Care Quality Commission in October alongside Five Ways Health Centre and the findings of the joint inspection published recently have rated care as ‘Outstanding’. Highlighted within the report is a new patient pathway for diabetes which was created in collaboration with Consultant Endocrinologist, Dr Ansu Basu together with GP, Dr Manir Aslam.

Sharing the finding of the report with Heartbeat, Broadway Health Centre Practice Manager, Noorin Akhtar said, “Dr Basu in collaboration with Dr Aslam created The Broadway Chronic Disease Population Management Pathway for Diabetes which was trailed out at Five Ways Health Centre whilst being care taken by Broadway Health Centre. This is an efficient, effective and innovative population management approach to chronic condition management. This has many benefits such as patient education; Real time clinical data based decision making, risk stratification and specialist consultant input and management of all the diabetic population group leading to better monitoring, control, earlier intervention, prevention of escalation and even remission.

The CQC inspection team were very interested in our programme and discussed it with Dr Basu. His discussion supported Broadway in achieving an ‘Outstanding’ rating.”

Highlighting the positive impact of the new pathway on patient care, the CQC wrote, “Data provided by the practice showed there were 230 patients on the diabetic register at Broadway and 209 had been through the eight care processes approach. The practice had adopted a pioneering responsive approach to delivering diabetes care through the Diabetes Chronic Disease Population Management Model Pathway. Following the pathway approach, the practice had seen an increase in improved management of patient’s diabetes from 18% to 83% in the first year.”

Well done, Broadway Health Centre and Dr Basu.

How you can support the domestic abuse team

Self-isolation, children off school and people working from home is stressful for all of us however this is an extremely risky time for victims of abuse.

Please ensure we are all asking the right questions such as “are you safe at home” and let victims know there is still help and support available in these uncertain times. They need someone to listen and believe and contact support services when necessary.

We have the Emergency Department Independent Domestic Violence Advocates based in City and Sandwell available during usual working hours:

City: 07989 843 233
Sandwell: 07823 336964
Safeguarding team: 0121 507 2844
National Domestic Abuse helpline (open 24 hours a day): 0808 2000 247

Note: Please remember if a victim is at immediate risk of harm they should dial 999.

For practitioners that may be supporting victims within the community further information for professionals can be found by clicking here.

National Express service information update

National Express West Midlands are currently running services as normal and will continue to do so until the last bus on Tuesday 24 March.

Starting from the first service on Wednesday 25 March, they will be running reduced services on some bus routes. No bus routes are being taken off, they will just be running some of them less often.

On all routes, times of first buses will be the same or within a few minutes of current times.
On all routes, there will be no change to the timings of the last bus.
Sunday services will remain as they are now.
Any National Express West Midlands all-night bus services will continue to operate.
Dedicated school routes will not be running due to the schools closing.

For more information please click here.

Parking at New Square Multistory Car Park

As of tonight the multi storey car park at New Square will be closed until further notice. Staff are advised that they can park on either Primark or Tesco Car park whilst the multistory is closed.

Revised opening hours: City retail

From 23 March the following outlets at city Hospital will have revised opening hours:

BTC Costa: Monday – Friday, 7.30am–2.30pm
Coffee Culture: Monday – Friday, 8.30am–2:30pm

We apologise for any inconvenience caused.

COVID-19 bulletin: Thursday 19 March

Our swabbing services for colleagues are now open and busy

Both our bungalow (near ED) at City and our drive through in the Little Lane car park at Sandwell Hospital are now open. If you have been experiencing symptoms such as a fever (above 37.8 °C) and new cough/consistent cough for over 24 hours you can book an appointment for a test by calling the community contact centre on 0121 507 2664 option 5.

Please do not just turn up! You can ring for appointments from Monday to Friday between 9am and 4pm. You will then either be given an appointment over the phone or you will receive a text with your appointment details.

Appointments are available at Sandwell 7 days a week from 9.30am to 3.45pm and at City, 6 days a week (Monday to Friday) from 9.30am to 3.45pm and Saturday from 9am until 1pm.

If you are unable to attend our sites, arrangements can be made for you to be swabbed at home via the community van. You will get your results as quickly as we possibly can from our occupational health team.

2. Guidance for colleagues given school closures

The government announced yesterday that all schools in England will close on Friday for the foreseeable future. They also said that school provision will be made for essential workers, including many people within the NHS. How that will work is not yet clear to us or educational colleagues. It may be the start of next week before it becomes clear.

Our nursery remains open and we are expanding places within it. We are also trying to create ‘clubs’ to support parents during term time and in the upcoming holidays. If you can get childcare that is satisfactory for your kids we will work with you to address increased costs that you are experiencing.

Your first day off to make arrangements will be classed as carer’s leave. Please contact your line manager. We will work sensibly with you to alter shift patterns and work flexibly to support you to help your family and help our NHS.

If you are a carer for older adults or other family members, we recognise this is a very anxious time. We continue to explore how we can help, and thank you for filling in our carer’s survey which closed yesterday.

3. Personal Protective Equipment (PPE): Follow our guidance

What PPE to wear is an evolving position. It is important that colleagues are fully aware of the correct PPE to wear.

Please watch this short video which explains what masks to wear:

We have also produced a pictorial about what to wear when dealing with a patient who is positive and one who is suspected.

If in doubt there is information available on Connect or you can contact the IPC team on ext. 5900. We want to ensure that you are safe at all times.

PPE can be collected from D18 and Bryan Knight suite from 8am – 8pm and from the site teams overnight. You will only be given PPE consistent with our guidance.

If you are a line manager and many of your teams do not use email, please make sure this message is shown to them.

4. Hotel accommodation for colleagues

You may find you have to remove yourself from your normal home, either to protect your loved ones or ensure you are able to help the NHS by staying well. We have identified for April more than 70 hotel rooms which are available for use. If you need a room booking please contact the team on swbh.hotel-booking@nhs.net

This is a key part of our work to reduce absence and avoidable self-isolation during coming weeks. Please take up this offer, which is happening NHS-wide, but at pace and scale @SWBHnhs.

In addition, we have got on-site accommodation available for up to seven days aimed primarily at people working exhausting shift patterns or live far away. You can connect with that offer through our accommodation service via IVOR. We have paused refurbishment work on some rooms while we face the first phase of COVID.

5. COVID-19 – getting the advice you need

We have two channels by which to get approved guidance to you:

This e-bulletin which provides clarity on how we are implementing any recommendations or policies from outside the Trust.
A clinician-specific bulletin covering treatment and pathway queries as we begin to understand more about how to tackle COVID.

Linked to this second option is an email address specifically for clinical queries about particular patients or diagnoses. Please do not use this for other queries. But you can reach David Carruthers and our medical director’s team via swbh.covid-queries@nhs.net

Occupational health are currently, like infection control, immensely busy. Remember you do not need to ring OH to self-isolate. Your line manager is the person to talk with.

From today we also have a central HR/workforce queries line to make sure we are applying our policies and evolving advice fairly and consistently: The team is available 8am to 6pm Monday to Friday via 0121 507 3116.

If advice is needed outside of these times, we have a dedicated HR email address for Covid19 workforce related queries swbh.hr-advice-for-covid-19@nhs.net

Finally, please register for myConnect. The phone app will give you all our COVID information at your fingertips at work, at home or on the bus! To download the app, go to Google Play or the Apple App Store and search SWBH myConnect.

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Monthly archives: March 2020

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