Monthly archives: May 2020

COVID-19 Bulletin: Saturday 2 May

Heartbeat: Sarah Peyton: Over 33 years of success

Sarah Peyton, Acute Medicine Nurse Practitioner will be retiring from the Trust after dedicating over three decades to the Trust and hospital care.

Sarah first began her journey at our Trust in 1987. Over years she gradually built up her career to become a ward sister which was shortly followed by her promotion to an acute medicine nurse practitioner in July 2007.

Sarah has played an instrumental role alongside Dr Sarb Clare, Consultant Physician in Acute Medicine in setting up a GP area which then changed to the AMAA (acute medicine ambulatory assessment) in 2014. As a result, Sarah, Sarb and the rest of the team went on be awarded the International Award from the Society of Acute Medicine for their work in AMAA.

Reflecting on her career, she remarked, “What I’m most proud of is my day-to-day work on the medical wards and working in AMAA. The job has changed over time, but I feel I have adapted to the changes whilst still being able to offer the best quality of care to our patients.”

Sarb believes Sarah has played a vital role at the Trust and in particular AMAA. She said, “Sarah has left a legacy for the organisation from developing and leading on nurse-led weekend discharges to being pivotal in developing and making ambulatory care a success. Her work has been invaluable and endless for both patients and colleagues.

“She is well-known by generations of both nurses and doctors and has supported many young doctors over the years. Sarah is loved by everyone.”

Upon retirement Sarah is planning to visit Africa as well as a Caribbean cruise with her family. She also hopes to visit Nepal again as she sponsors a little girl to go to school there.

Thank you for your hard work at the Trust Sarah – happy retirement!

COVID-19 Bulletin: Friday 1 May

This is our every single day bulletin. Please use this bulletin and cascade arrangements within care and corporate groups to guide your actions. Remember KINDNESS is our watchword in implementing our plans.  Throughout May we are determined to reduce avoidable harm and death in the people we are taking care of.

Hand-washing week next week!  It is hand washing week every week of course but in the week ahead we want to ‘go again’ with our emphasis on this key action for patients, the handful of visitors, and all of us, students, volunteers and staff.  How many times a day?  In your hotel or at home?  Do you sing and if so what?  Are you lathering enough?  Back of the hand, both hands.  The benchmark is 70 and was set on the Chief Executive’s WebEx on Wednesday.  Let’s make it part of what we do round here…

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

1. We are recruiting, tell your friends…
We know that the real economy is going to face the impact of recession in the months ahead.  We know that unemployment is a health issue.  We know that people want to work, and we want to train and to employ.  The Trust continues to look for talented individuals to join our team, with vacancies in a number of areas. Colleagues who recommend a friend who is then appointed will receive £100 along with the new recruit.  Remember for many services, as Covid is surmounted, we get ready for the big move to Midland Met – so there has never been a better time to join the Trust.You never know when the next opportunity may arise – so keep informed of new opportunities for on NHS Jobs, as well as our recruitment page on Facebook and official LinkedIn account.  The Trust is exploring how job roles may change as a result of Covid-19, and in particular how we support hybrid roles for people working in different jobs, with the variety of a brigade or the span some of our clinical redeployees are really enjoying. 

2. BTC and BMEC set to scrub up well
The best way to stay safe and to prevent the virus from spreading is by keeping yourself and our premises clean. This is why it is all the more important right now to arrange for deep cleans to be carried out.

In preparation for our recovery phase we are deep cleaning the Birmingham Treatment Centre, which includes all theatres, clinical areas and public areas over this weekend.  The Trust is getting ready to re-start some selected clinical work for non-Covid planned patients.  Again, important to get the word out, as the country moves through coming changes to lock-down.

3. Shielding:  Let’s learn from you
About 150 Trust employees are currently shielding.  Remember if that is you, you must provide the right documentation to our Human Resources function.  We will be regularly in contact with you through our Wellbeing Team at this tricky and difficult time.

Ten days ago we issued over 2,500 further patient facing shielding requests.  As that implies we are expecting shielding to continue in some form beyond the initial changes to lockdown which could arise in May.

We are working with primary care colleagues generally and Trust GPs and community teams in particular to think through how best we support people shielding.  We will be in touch next week with ‘our own’ shielders to ask that question, but through your local management team do let us know how you and your service feels we could best support the shielding community.  As time goes by clinical advice beyond stay home is needed and we will be working to mobilise specific teams to ensure we reach everyone in our community facing a prolonged period of separation.

4. Supporting Black and Minority Ethnic employees
Earlier this week we included revised guidance in this bulletin associated with elevated risk and elevated anxiety among BaME key workers about Covid-19.  The commitment to address both the evidence and the concern is absolute.  NHS Employers have just ssued useful advice on how the issue may best be addressed by health service organisations.  Reviewing that suggests the Trust is already doing all of this best practice, although we need to check that that work is happening everywhere.  However, if you remain concerned and wish a new Risk Assessment of your work practice to be carried out, or an existing risk assessment to be challenged, please do any of the following three things:

• Talk to your line manager who will work through the options with you
• Contact our HR advice line on 3116 who will work ‘independently’ with you
• Contact tobylewis@nhs.net who is the executive sponsor for the Trust’s Black and Minority Ethnic Staff Network, who will oversee work to support you

5. May Bank Holiday, it’s different 
Friday May 8^th is the first bank holiday, not Monday.  But other than that it’s going to be normal.  So thank you to everyone who worked differently over the Easter Bank Holiday at our first Surge peak.  Whilst none of us can predict the future, our current plan is for this first May bank holiday to be just that.  If you don’t have to work, #stayhomesavelives.

Toby recently took part in a conversation with podcaster Desmond Jaddoo to tackle a local viral video about care with COVID-19, as well as to discuss candidly local and national data on gender, age and ethnicity. You can watch that video here.  The Trust continues to advocate for enquiries into national data on ethnicity and Covid-19 to help inform care and practice.

Chief Executive’s Message – Friday 1 May

Susan, Natalie, Justine, Ruth, Andrew, Kulwinder, Joanne, Faye, Denise, Louise, Javier, Wasim, Rachel, Sophie, Marian, Nicola, Davinia, Surinder, Julie, Rebecca, Joanne, Linda, Sally, Kerry, Nasha, Tracey, Amanda, Megan, Anj, Pushy, Laura, Harriet, Jackie, Harry, Kashif, Lisa, Lisa S, Liz, Peter, Mercy, Sukhpal, Karen, Jayne, Andrew, Malcolm, Jag, Mel and everyone in the community contact centre please take a bow!

These are the team who this week stood up our latest testing venture, the community asymptomatic test pilot (two and a bit days labour at a few hours’ notice…).  We managed to swab over 700 colleagues in two days. This sits alongside the 1,500 or so symptomatic tests we have done so far, and the 650 tests a day being delivered through the Midland Metropolitan University Hospital key worker drive through. Of course it is encouraging that we are getting good access now, and that colleagues from black and minority ethnic backgrounds are in particular well represented in these cohorts. It is clear from staff feedback that being tested can be a reassuring experience, albeit as I tried to explain to the Express and Star this week, we need to keep a precautionary mind-set at all times, tested or not tested, with a test whose sensitivity is at best about 80 per cent. A number of you have written to me recently about antibody testing, and no news definitively on that yet, albeit we sense the pace is quickening. More and sooner news on home testing, that may be out very shortly, which will help in making sure that housebound and especially vulnerable people who need clarity are best able to get it. If you are unsure how to get yourself a test, please do get in touch. The systems remain at times bewildering but I do want to reassure that there is a real change in scale and emphasis now in support of workforce testing and that is something we need to seize on.

I took my first gentle steps this week into my weekly cleaning shift. Touchpoint cleaning is a key part of how we make sure that the environment we are working in is as safe as we can make it. I see colleagues using elbows to open doors, and other bits of the anatomy. All welcome, but only if it is alongside both our cleaning work and your handwashing. That is why next week is our Handwashing Week where we want to generate momentum around making handwashing routine and obsessive, but also understand what gets in the way in specific parts of the organisation – more gel, better access to basins, somewhere to secure your jewellery or watch, and the rest. Doing that publicly is not just about creating buzz it is also part of making sure that we work together to reassure local residents about the safety steps we are taking in healthcare settings. The same intent sits behind the mass deep-clean this weekend of the Birmingham Treatment Centre, which will form a key part of our re-start work for non-COVID19 care in coming weeks. Patients are worried about coming into healthcare settings and we need to work to provide evidence and visibility to our efforts to address that fear.

Fear is often well informed of course, but still needs to be addressed. We have spent time over the past fortnight talking a lot about the risks and concerns faced by patients and by colleagues from the BME community. On the one hand, we can demonstrate our own care data which largely reassures about rates of positive tests or mortality. On the other, we can all see the startling national key worker data – not just from acute or high risk settings – which leads to heightened risk assessments.  We have had a flurry of national guidance this week on that topic and are working through this weekend whether there is anything in that guidance that we have yet to do. The COVID-19 bulletin included this week some comments on Vitamin D, and today we provide clear guidance on what to do if you remain concerned in the workplace. We will continue to work internally to understand both the local data, regional best practice, and to listen to staff about their thoughts. As shielding numbers grow and evidence accumulates we will want to both respond practically to needs and make sure that our guidance as it changes is the practice where you work. Just this week I came across pregnant colleagues who have not been able to access our guidance from mid-April or have access to home-working, and some medical secretarial colleagues in the Eye Hospital who had not felt able to work from home despite our April 7th document. I guess my point is twofold – our policies will change over time, so always worth keeping up to date via our bulletin, and vital that if the Trust-wide approach is being derogated locally you speak up and we look into whether that is agreeable.

This week there was publicity for COVID-19 in children and young people, which I know our team have in hand. We have seen a huge drop in presentation among children, both to GPs and hospitals.  Worries flow from that, but also questions as measures of harm have not all risen as one might from such low presentation rates. As we consider how to restore service we need to make sure that we take this opportunity to look again at what works best and how our plans fit with the clinical models that we will have in 2022. Children’s acute services are a great example of that – with the new ED-PAU due to open at City in a few weeks, and learning from our moves of paediatric ED towards the ward at Sandwell as well. Children’s surgery will all be in one place in two years’ time and so we are finalising our plans for how to deliver a model on those lines sooner rather than later.

Safety always has to be central to both our plans and our review. It is widely known, but now in international media, that we took delivery of some ventilators before Easter, which we tested and declined to use. I know that the clinicians involved felt supported in reflecting their concerns and that the Board was unambiguous that issues of safety are local decisions. At the same time, this week we have been reviewing whether our COVID-19 service model for haematology is right, and our own decision making is therefore under scrutiny. As we go through a few weeks of comparing services last year, to services now, to our longer term model, we need to use both data and feelings to consider how we get the right balance. Quality judgments will vary, safety judgments ought to be clear-cut. What though is evident, from the last few weeks, is that it is possible for us to make decisions rapidly and experiment at pace. That is a mind-set that we want to keep, which is why our May 13th QIHD will provide a place for teams to co-construct and feedback your thoughts on what has worked well during the last two months where you work. Terrific earlier today to listen to our nuclear medicine leaders talk about their experience and the expertise they have shared nationally – and of course about our forthcoming PET scanner launch!

Home working is surely part of our future, just as Visionable will be clinically. On May 14th we are hosting the first of some regular WebEx chats to see how best to facilitate that, either for long term home workers, or for those who may be shielding or isolating until the autumn. We need to challenge the sometimes implied notion that such home working set ups must be less productive and be challenging of our own perceptions about what work truly means. This is perhaps especially complex for people whose job is managing other people, as so much of how that typically is done is by face to face informal contact. As we re-start the PDR cycle in May, with the aim of completing by July 31st, it is worth managers and those they manage talking through how you communicate best, what works, and what does not.

Next week Heartbeat should be delivered and go up online. Packed as ever with details of changes you have made, awards won, and opinions shared. My column is focused on how we carry our story forward towards Midland Met. I am delighted that it looks probable that ourselves, the Combined Authority, both councils and the Canals and Rivers Trust will form a shared enterprise to help regeneration between Dudley Road and Rolfe Street. As the area and country faces recession, investment and regeneration are absolutely crucial. Poverty is a health issue and you can expect, and ought to expect, that we will talk firmly and act clearly to do what we can to address poverty in our communities, as we have in our workforce place by being a Real Living Wage employer.

Next week too we change approval arrangements for agency expenditure. This is bound to be awkward and cause a fuss. The motive is twofold. Firstly let’s truly understand why we are using agency staff. As services have scaled back, our agency has not always fallen. That suggests a certain habitual reliance. Secondly, if we want to spend £20m a year on new equipment and invest £4m a year in creating new services, we have to make £18m of cost improvements happen. The profit we hand over to agencies is part of that story. Let’s work together through May and June to make sure that we are investing now for the medium term, and dialling back spend outside our need or governance. I am sure we will do that with the candour and conversational honesty that has marked the last few weeks approach to COVID-19.

Every day we publish data on the pandemic. We have passed this week a milestone with our 1,000th diagnosis. Equally sadly it is likely we will reach 300 deaths. I know we are doing everything that we can to test at pace on admission, prone as required and get oxygen therapies right. Thank you for all that you are doing. By being open with our data, recognising the humanity behind that, and talking thoughtfully with local residents about what is really going on, we will move towards those #greenshoots where services open again and we begin to tackle all the care needs of those we serve.

#hellomynameisToby

ESR downtime this weekend

Colleagues are advised that the ESR production service will be withdrawn at 6pm today (Friday 1 May 2020) in order to carry out essential ESR Production maintenance.

This period of downtime for the ESR production service will run until 10am, Sunday 3 May when the ESR production service is expected to become available.

Users are asked to note the 6pm closure time for the on-line service and co-operation is requested to ensure that all users are logged off by this time.

ESR, e-learning, ESRBI, ESR data warehouse, ESR portal and TRS will be unavailable during this period of downtime.

Please ensure you log in and approve any pending notifications.