Monthly archives: May 2020

Let’s help you look after you

Dealing with the pandemic has put a toll on many of us, working longer hours, having feelings of anxiety and even fear. It is therefore now, more important than ever, to look after your own health and wellbeing. A range of resources and support are on offer for all colleagues including 24/7 access to confidential counsellors including a wealth of support and information on our dedicated Connect pages.

The Trust has also turned the building which hosted the Live and Works team into a  wellbeing sanctuary. It is open and available to you five days a week offering a range of services including massages, meditation, mindfulness and hypnosis.

We caught up with Lawrence Kelly, Learning Works Co-ordinator who told us the sanctuary was developed in response to the pandemic.

He said: “None of us have ever experienced working in a pandemic. The stress COVID-19 has placed on colleagues has been immense, and as a team we realised we needed to provide a service where colleagues could come and get away from everything even for half an hour.

“The wellbeing sanctuary is a place where colleagues can share their stories and off load about their anxieties and fears. We have decorated the rooms to have the effect of calmness, with candles and relaxing music.”

Lawrence continued: “We have been both surprised and pleased with the uptake of the service. We are seeing colleagues from a wide range of professions including senior clinicians and wards service officers. Colleagues are coming here, seeing the benefit and then spreading the word to their own teams.”

A ward services officer who has been visiting on a regular basis told us: “I have been off work with anxiety and the help I am getting here is really helping me to get my mind ready so I am able to return to work. The colleagues here are wonderful, I would definitely recommend it.”

A staff nurse added: “I have recently recovered from COVID-19 and have returned to work. I have visited the wellbeing sanctuary twice so far and I am finding it very beneficial in my role. The meditation and therapy relaxation massage is very good. It is very helpful in dealing with anxiety.”

The sanctuary currently sees up to 15 colleagues a day. The team have extended the service to include colleagues from primary care and care homes. The first time you visit the sanctuary you are asked to complete a short questionnaire based on the Warwick-Edinburgh Mental Wellbeing Scales which assesses your mental wellbeing. The assessment is reviewed at each visit to track progress.

The wellbeing sanctuary is based at the Learning Works, Unett Street, Smethwick, B66 3SY. Daily sanctuary sessions include:

• Deep Relaxation and Breathing through Soundscape – Travel from the peaks of the Himalayas to the depth of the oceans of Bali relaxing in a harmonious tranquillity.
• Music Therapy – A time to find inner stillness through the tranquillity of relaxing sound vibrations.
• Restorative Clinical Supervision (Health and Wellbeing Lead) – A safe and confidential space to explore the impact of work pressures.
• Unwind with Mindfulness – Breath and Relax. Enjoy the session of being present and the power of connection and self-kindness.

To book an appointment contact the team on 0121 507 5886.

National Breastfeeding Celebration Week

National Breastfeeding Celebration Week begins tomorrow (1 June), and our Infant Feeding team has reported a rise in rates – partly linked to the coronavirus pandemic. Led by Louise Thompson, the team are continuing to support new mums by holding face-to-face and virtual clinics, giving them reassurance and advice. Rates have increased by 6 per cent to 86 per cent. Mums have told the team that they are able to spend more time at home practising and learning how to feed their babies.

Breastfeeding during the pandemic remains as important as ever, as an initial study of breast milk expressed by mothers recovering from COVID-19 found specific IgA antibodies against the virus in 80 per cent of milk samples. COVID-19 virus has not been found to be transmitted in breast milk, unlike other body fluids.

Please continue to support women to breastfeed if that is what they want to do, as it is designed to be protective – it isn’t just nutritional. When women are exposed to bacteria and viruses their body responds by sending specific antibodies to breastmilk. For more information on the protective nature of breastfeeding watch this film – https://www.youtube.com/watch?v=iqDX7Hojojk

For more information about all aspects of infant feeding including mixed feeding and formula feeding, please contact the Infant Feeding team on 07816061633. If you’ve had a difficult feeding experience, no matter when and would like someone to talk to about it you can contact Louise Thompson on 07976499507 or louisethompson@nhs.net.

Supporting our care homes

Through the work of our community teams, we have strong relationships with many care homes that are sited within the Birmingham and Sandwell areas. During the COVID-19 pandemic we enhanced the support that our dedicated care homes team provides by extending to a seven day service. We worked with care homes, local authority and public health colleagues to develop a daily reporting system that tells us which care homes need support that can include training, clinical advice, help with equipment, PPE and FIT-testing. Our teams are helping with end of life care and infection prevention and control advice including our PPE van that has visited homes to provide on-site training in donning and doffing. Care homes have been part of our community swabbing response and some of our shielding colleagues are providing regular telephone advice and support.

Donations received by the Trust are routinely shared with care homes and one of our partner charities, Kissing it Better, have been out visiting care home providing socially distanced entertainment outside for residents to enjoy from their windows. Care homes are an essential part of the health and social care system so it is vital that they form a central part of our COVID-19 response.

COVID-19 Bulletin: Sunday 31 May

This is our seven days a week bulletin. Please use this bulletin and cascade arrangements within care and corporate groups to guide your actions. Throughout June we are determined to reduce avoidable harm and death in the people we are taking care of. Kindness remains the guiding principle of all the actions in our work to tackle the virus – kindness in how we look after patients, visitors, and one another.

We understand today that the government has relaxed some parts of its shielding guidance. Staff who are shielding are under no obligation to return to the workplace. We will continue to work with you as individuals as the national policy position evolves over the coming weeks. The personalisation of the COVID-19 strategy locally means we need to understand specific risks, and our new risk assessment tool which goes live this Thursday will help us to do that.

Numbers not statistics: Today’s totals (Yesterday’s totals)

1. Do you wash your hands the NHS way?

Washing your hands thoroughly and frequently is essential to prevent transmission of COVID-19.

All colleagues must wash their hands or use hand sanitiser on entering and exiting clinical areas. You are reminded of the five moments of handwashing:

1. Before touching a patient
2. Before clean/aseptic procedures
3. After body fluid exposure/risk
4. After touching a patient
5. After touching patient surroundings.

Read the full article here.

2. Health and safety review of office accommodation

From next week the Trust’s Health and Safety team will begin visits to all of our office accommodation. The purpose of their visit is to risk assess each workplace in light of the government’s guidelines on working safely during COVID-19 in offices and contact centres, that is supported by PHE and the Health and Safety Executive.

The team will aim to cause as little disruption as possible but may need to take some measurements of distances between desks for example, in which case you may need to leave your office for a few minutes. The results of the office risk assessments will inform our discussions on future ways of working, including working from home.

3. Supporting care homes

Through the work of our community teams, we have strong relationships with many care homes that are sited within the Birmingham and Sandwell areas. During the COVID-19 pandemic we enhanced the support that our dedicated care homes team provides by extending to a seven day service. We worked with care homes, local authority and public health colleagues to develop a daily reporting system that tells us which care homes need support that can include training, clinical advice, help with equipment, PPE and FIT-testing. Our teams are helping with end of life care and infection prevention and control advice including our PPE van that has visited homes to provide on-site training in donning and doffing. Care homes have been part of our community swabbing response and some of our shielding colleagues are providing regular telephone advice and support.

Donations received by the Trust are routinely shared with care homes and one of our partner charities, Kissing it Better, have been out visiting care home providing socially distanced entertainment outside for residents to enjoy from their windows. Care homes are an essential part of the health and social care system so it is vital that they form a central part of our COVID-19 response.

4. Let’s help you look after you

Dealing with the pandemic has put a toll on many of us, working longer hours, having feelings of anxiety and even fear. It is therefore now, more important than ever, to look after your own health and wellbeing. A range of resources and support are on offer for all colleagues including 24/7 access to confidential counsellors including a wealth of support and information on our dedicated Connect pages.

The Trust has also temporarily turned the building which hosts the Learning Works team into a wellbeing sanctuary. It is open and available to you five days a week offering a range of services including massages, meditation, mindfulness and hypnosis.

The wellbeing sanctuary is based at the Learning Works, Unett Street, Smethwick, B66 3SY. Daily sanctuary sessions include:

1. Deep Relaxation and Breathing through Soundscape – Travel from the peaks of the Himalayas to the depth of the oceans of Bali relaxing in a harmonious tranquillity.
2. Music Therapy – A time to find inner stillness through the tranquillity of relaxing sound vibrations.
3. Restorative Clinical Supervision (Health and Wellbeing Lead) – A safe and confidential space to explore the impact of work pressures.
4. Unwind with Mindfulness – Breath and Relax. Enjoy the session of being present and the power of connection and self-kindness.

To book an appointment contact the team on 0121 507 5886. Read the full article here.

5. National Breastfeeding Celebration Week

National Breastfeeding Celebration Week begins tomorrow (1 June), and our Infant Feeding team has reported a rise in rates – partly linked to the coronavirus pandemic. Led by Louise Thompson, the team are continuing to support new mums by holding face-to-face and virtual clinics, giving them reassurance and advice. Rates have increased by 6 per cent to 86 per cent. Mums have told the team that they are able to spend more time at home practising and learning how to feed their babies.

Breastfeeding during the pandemic remains as important as ever, as an initial study of breast milk expressed by mothers recovering from COVID-19 found specific IgA antibodies against the virus in 80 per cent of milk samples. COVID-19 virus has not been found to be transmitted in breast milk, unlike other body fluids.

Please continue to support women to breastfeed if that is what they want to do, as it is designed to be protective – it isn’t just nutritional. When women are exposed to bacteria and viruses their body responds by sending specific antibodies to breastmilk. For more information on the protective nature of breastfeeding watch this film – https://www.youtube.com/watch?v=iqDX7Hojojk 

For more information about all aspects of infant feeding including mixed feeding and formula feeding, please contact the Infant Feeding team on 07816061633. If you’ve had a difficult feeding experience, no matter when and would like someone to talk to about it you can contact Louise Thompson on 07976 499507 or  louisethompson@nhs.net.

Do you wash your hands the NHS way?

Washing your hands is an essential part of infection prevention and control. All colleagues must wash their hands or use hand sanitiser on entering and exiting clinical areas.

Clinical colleagues are reminded of the five moments of handwashing:

1. Before touching a patient
2. Before clean/aseptic procedures
3. After body fluid exposure/risk
4. After body fluid exposure/risk
5. After touching a patient

Washing your hands is one of the simplest ways you can protect yourself and others from illnesses. Washing your hands properly removes dirt, viruses and bacteria to stop them from spreading to other people and objects, which can spread illnesses. It can also help stop people from picking up infections and spreading them to others.

As we all try to navigate life with the threat of COVID-19 we’ve highlighted some easy to follow steps to ensure your hands are squeaky clean:

• Wet your hands with water
• Apply enough soap or hand wash to cover your hands
• Rub your hands together
• Use one hand to rub the back of the other hand and clean in between the fingers. Do the same with the other hand
• Rub your hands together and clean in between your fingers
• Rub the back of your fingers against your palms
• Rub your thumb using your other hand. Do the same with the other thumb
• Rub the tips of your fingers on the palm of your other hand. Do the same with other hand
• Rinse your hands with water
• Dry your hands completely with a disposable towel where possible
• Use the disposable towel to turn off the tap.

Health and safety review of office accommodation

From next week the Trust’s Health and Safety team will begin visits to all of our office accommodation. The purpose of their visit is to risk assess each workplace in light of the government’s guidelines on working safely during COVID-19 in offices and contact centres, that is supported by PHE and the Health and Safety Executive.

The team will aim to cause as little disruption as possible but may need to take some measurements of distances between desks for example, in which case you may need to leave your office for a few minutes. The results of the office risk assessments will inform our discussions on future ways of working, including working from home.

COVID-19 Bulletin: Saturday 30 May

This is our seven days a week bulletin. Please use this bulletin and cascade arrangements within care and corporate groups to guide your actions. Throughout June we are determined to reduce avoidable harm and death in the people we are taking care of. Kindness remains the guiding principle of all the actions in our work to tackle the virus – kindness in how we look after patients, visitors, and one another.

Thank you to everyone working this weekend, so diligently, to look all our patients, perhaps particularly those with COVID-19.  Letters are now going to those who have been redeployed to outline when you will be able to return to your job.  We continue to have more patients affected by the virus than many other local hospitals, and so you should not be surprised if our pattern of return is slower than neighbours.  Social distancing in the community, the take up of trace arrangements, and the spread of antibody testing will determine how we go forward over coming weeks to restart services that we stood down in March.

Numbers not statistics: Today’s totals (Yesterday’s totals)

1. Antibody testing – you can book your appointment this weekend

You can now book yourself an antibody test for COVID-19 with tests starting on Monday 1 June at the Trust. Any staff member can arrange a blood test, whether you have previously had a positive or negative test result for COVID-19 or no COVID-19 test previously. For the test to be accurate you must have no COVID-19 symptoms and be symptom-free for at least 21 days.

The presence of antibodies is no guarantee against catching or spreading COVID-19 so it remains really important to wash hands thoroughly on a regular basis and maintain social distancing both in the workplace and at home, regardless of the results of your antibody test.

To book a test please call 0121 507 6104 and select option 2 when prompted.

Results of your test will be e-mailed to you from occupational health within 72 hours of having the test. You can find out more in this questions and answers document. For more information please click here.

2. Did you know you can get fit tested on the weekend?

PPE stocks are ever changing as stocks are replenished and new masks become available. Currently we are running low on Alpha masks which is why it is critical that colleagues stay up to date with the availability of masks that they have been fit tested for.

Should you need to be fit tested clinics are available this weekend between 8am and 8pm. To book yourself into one of the fit testing clinics simply call 0121 507 5050 to book an appointment.

3. COVID-19 Preprint Repository now available

Our library team remain hard at work bringing you all the latest updates and information relating to COVID-19 based on clinical evidence. If you are looking into COVID-19 and want recent research information you can access medRxiv:

medRxiv (pronounced “med-archive”) is a free online archive and distribution server for complete but unpublished manuscripts (preprints) in the medical, clinical, and related health sciences. The medRxiv preprint repository listing all the COVID-19 SARS-CoV-2 research has been launched for easy access for all healthcare researchers https://connect.medrxiv.org/relate/content/181

The Library page on Connect has a new section on COVID-19 evidence updates and the team are keen to help with any COVID-19 related literature searches. Please email your topic request to swbh.library@nhs.net.

4. Continue to maintain social distancing! Don’t stand so close to me…

Though we are past the first peak of COVID-19, social distancing remains paramount both in the workplace and at home. Social distancing is an effective way to help slow down the spread of COVID-19 thus keeping us safe.

Remember: Social distancing only works if everyone participates. Slowing down the spread of COVID-19 will help save thousands of lives – we are all responsible for protecting those at higher risk of COVID-19.

5. Unity update for COVID-19: Diagnosis code

Informatics has confirmed that, thanks to an update to the SNOMED CT Clinical Terms library, COVID-19 is now available as a diagnosis.

The new ‘COVID-19’ term has been placed into the notifiable disease folder in Unity, this replaces the previously used phrasing “Disease caused by 2019 novel Coronavirus”.

Please note: This diagnosis is not yet available for ED as the UK ED Diagnosis Subset has not yet been updated.

COVID-19 Bulletin: Friday 29 May

This is our seven days a week bulletin. Please use this bulletin and cascade arrangements within care and corporate groups to guide your actions. Throughout May and June we are determined to reduce avoidable harm and death in the people we are taking care of. Kindness remains the guiding principle of all the actions in our work to tackle the virus – kindness in how we look after patients, visitors, and one another.

2 metres apart.  Walk around our site and do your best to make sure you are observing this.  All of us could be a spreader.  Antibodies are not a protective shield that changes that.  As we all face the complexities of schools opening, football restarting, sunshine and summer, it is even more important that we get the basics right.  So if your workspace means social distancing feels impossible, please speak up and we will try and find alternatives.  In the week ahead let’s really try and make it ok to ask colleagues Don’t Stand So Close To Me….

Numbers not statistics: Today’s totals (Yesterday’s totals)

1. Antibody testing

Testing for antibodies to COVID-19 begins on Monday 1^st June, with the telephone line to book your appointment also open this weekend from 8am to 4.30pm. Be aware that telephone lines are likely to be busy.

You must be symptom free for 21 days prior to being tested, to ensure the test will give an accurate result. There is no point in colleagues undergoing the test to get a false result. To book a test please call 0121 507 6104 and select option 2 when prompted. Results of your test will be e-mailed to you from Occupational Health within 72 hours of having the test.

Whatever the result, you must continue to follow the infection prevention and PPE guidance in full. Observe strict hand hygiene at all times, keep social distancing two metres from people outside your household and wear PPE according to guidelines when seeing patients in clinical areas. You will also need to follow Occupational Health guidance on self-isolating and testing if you develop symptoms of possible COVID-19 in future.

• You can view an overview of the employee antibody and swab testing process here.
• An updated version of the Q&A for antibody testing can be found here.

2. Test and Trace notifications

Colleagues will have heard about the launch of the Test and Trace service across England, which aims to help identify, contain and control coronavirus, reduce the spread of the virus and save lives. Anyone who tests positive for coronavirus will be contacted by NHS Test and Trace and will need to share information about their recent interactions. This could include household members, people with whom you have been in direct contact, or within two metres for more than 15 minutes.

If you receive notification from the Test and Trace service you may be advised to self-isolate for 14 days. Under these circumstances you should follow this guidance, but if you have developed antibodies you may be able to return to work so please book your antibody test. In line with the usual guidance if you develop symptoms you must stay at home for at least seven days and advise your line manager. On receiving a notification from Test and Trace please alert your line manager. If you are unsure what you should do you can contact Occupational Health for advice.

3. Sandwell Deep Clean: P5 this weekend

A detailed schedule is in place to deep clean our wards at Sandwell Hospital. This involved moving patients into other wards, and completing a thorough clean before the ward can begin accepting patients again. We will use N1 (OPAU) as the decant ward where required.

This weekend the work begins on deep cleaning P5. Thank you to all the colleagues who are safely moving patients and to the ward service officers who are completing the deep clean work. The deep clean continues in Sandwell throughout June and then will move to City Hospital. Please contact Paula Gardner if you have any queries.

4. New risk assessment tool for C-19 in our workplace

Further to discussions over the last three weeks, and specifically conversation with Black and Minority Ethnic employees in a special forum held last week with the medical director, the Trust will launch the new assessment tool on Thursday June 4th.  Anyone wishing a new assessment should telephone Occupational Health on 0121 507 3306 to book a slot over the coming month, you can also email swbh.riskassessmentoh@nhs.net.

The tool seeks to analyse the known contributory factors to the disease as the evidence currently stands.  The position is clearly a dynamic one and the tool will evolve under Occupational Health medical advice over time.  Because the tool is a clinical one, any risk assessments will be done through OH rather than line managers to ensure patient confidentiality.

5. Working from home: Updated guidance

On Wednesday we published new interim guidance on working from home. This guidance is valid up to 31 July 2020 and covers those roles that are recommended to be home-based at present. People who are shielding should continue to WFH. Three things are required for people working from home which are: Complete your PDR via Webex; Talk to your line manager if you feel you can do 85% of your role from home and you are not currently WFH; and, arrange to spend a full day on site once a week or fortnight. You can read the full guidance here.

If you are WFH you may have received a laptop or desktop to take home. You must log onto this computer whilst still on Trust premises to ensure you can connect to the SWB network. Your computer will not work at home unless you do this. This cannot be resolved remotely so you need to return to site to sort it. Contact the IT Helpdesk 24/7 on extension 4050.

Star of the Week – Joanne Tonks

This week’s Star of the Week goes to Joanne Tonks, osteoporosis nurse.

She was nominated by numerous colleagues for the way she has co-ordinated the Trust’s COVID-19 community swabbing teams. Joanne has been praised for her support to all colleagues who have been deployed into the swabbing response, ensuring that they are suitably trained and kept up to date with the latest guidance. She is always been available for help and has made sure that we continue to provide an excellent swabbing service for colleagues who have symptoms, their family members and care home colleagues.

Do you know someone in your team that has gone above and beyond the call of duty? Why not put them forward for Star of the Week by clicking here.

Chief Executive’s Message – Friday 29 May

Antibody testing for COVID-19 launches on Monday at the Trust. In truth our understanding of the science of the disease means we have incomplete knowledge of how and for how long such antibodies might protect an individual. Notwithstanding, unless you currently have symptoms or have had in the last 3 weeks, we are suggesting you do get tested. However, it is really important that regardless of your test result you continue to:

• Wash your hands obsessively
• Maintain social distance at work and at home
• Wear, and correctly take on and off, the right Personal Protective Equipment

This week I have had occasion to insert into our bulletin a reminder about covering uniforms when travelling, or buying groceries, and about not wearing scrubs off site. I guess in the same vein of restatement, it is worth noting that gloves and aprons must be changed between patients. All of these nudges are about how we work together to maintain vigilance over the summer while we continue to manage the virus.

Today in our Board’s quality and safety committee we looked at ‘cross infection rates’ of patients who may have been admitted without COVID-19 and then developed it, perhaps from another patient, or more likely from one of us. Rates of cross infection appear lower in the Trust than elsewhere, but may be rising. That suggests that, even as the national position appears to be being relaxed, we need to take great care of ourselves and those entrusting themselves to us. That is why we are maintaining extra cleaning in clinical environments, and why Wednesday’s Working From Home guidance maintains and indeed expands such arrangements between now and the end of July. All of us have a part to play in making sure our behaviours help to curtail COVID-19 spread.

Next Thursday we launch our revised employee risk assessment protocol which aims to understand the various risk factors that someone might have which could make them more susceptible to the virus. Masood Aga and the occupational health team have worked to develop this, alongside senior clinicians. The bulletin will explain how to access an assessment, and, as I wrote last week in terms of my discussions with BAME colleagues, this assessment will then drive a high, medium or low risk rating. On a person by person basis we will then act on the results, with the most likely outcome of a medium rating being revised PPE for an individual.

It is foreseeable that as COVID-19 becomes more personalised, with some having antibodies, and changed equipment that is individually allocated not just locational, there is a risk of stigma arising.  Sadly, this could be societally linked to higher risk groups – and prejudices could come to the fore, or indeed unconscious bias. We need to work together to recognise that any of us could have or spread COVID-19, and whilst we have to make it ok to discuss individual risk factors, we need to make sure that no-one feels they are being avoided or shunned or treated differently because of the disease.  As I began this message with, all of us have a 2m exclusion zone around us, even if now we can see some of friends and family in next door’s garden in the sunshine.

This week’s Star of the Week is Joanne Tonks, Osteoporosis Nurse, who was nominated by several colleagues for the way she has co-ordinated the Trust’s COVID-19 community swabbing teams. Jo has been praised for her support to all staff who have been deployed into the swabbing response, ensuring that they are suitably trained and kept up to date with the latest guidance. She is always available for help and has made sure that we continue to provide an excellent swabbing service for staff who have symptoms, their family members and care home staff. Thank you, Jo.

During June we will see most colleagues moving back to prior roles. I very much hope that where new skills have been learnt there is a chance to keep those skills and with that in mind we are looking at hybrid roles and second role specifications. As we move towards winter, let alone a second surge, we need to consider how best to retain acute and assessment skills developed during the pandemic. At the same time, we need to recognise that some roles are changed forever by the pandemic. Outpatient nursing is, for instance, a specialist skill. But the advent of video-based consultations will change the job in very many ways. As we move through June we will look to make sure we develop support programmes for roles where that transformation is evident – for example anyone who line manages someone may need help with simulating how to do so if that employee works from home. It’s a subtle message – not everything is changed by COVID-19 but everything is touched by it. Some of the energy from the pandemic across the Trust has come from making experimental change at speed without waiting for extrinsic instruction and we want to try and maintain that sense of getting on with things that will improve care.

Last week we handed out our second ever QIHD Gold Award, this time to Trauma and Orthopaedics.  I write about that in this month’s edition of Heartbeat (available on line and in wipe-able print). The team’s story continues but started with a safety summit about avoidable harm and possibly deaths.  The review of COVID-19 deaths as a Trust for March and April will feature in June’s QIHD learning pack, with six cases where practice could have been improved (even if death was probably not avoidable). The honesty of using this data transparently and committing to make change, and the dedication to talk as a team in QIHD time and make that happen, is the golden thread we have been trying to create at the Trust over many months and years. Let’s recognise such successes in our Star Award nominations in June, and document our learning in the QIHD Posters we develop for December’s contest.

#hellomynameisToby