Monthly archives: May 2020

COVID-19 Bulletin: Friday 15 May

This is our every-day bulletin. Please use this bulletin and cascade arrangements within care and corporate groups to guide your actions. Throughout May 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’re worried.  Worried that as we get tired, weary and exhausted, local departmental infection control habits are slipping.  Two metres, the right PPE, changing your PPE between patients as guidance requires, not wearing scrubs on the bus or to the shops, making sure you wash your hands dozens of times a day.  It can harder still to challenge others, because we know how hard everyone is trying.  But this month and next month, tonight and tomorrow, we have to keep going.  Please be part of the effort – the effort to get this right.  Thank you.

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

1. Please prone when it is needed

We are working every day to save lives.   Please make sure you do two things:

Our guidance on awake proning covers length of time, positioning and the importance of consent. You can also watch a demonstration of the positioning in the video above.

We must also record patient proning in Unity using the Awake Prone Position (APP) PowerPlan. A Quick Reference Guide (QRG) has been developed to guide you through the steps you need to take to record proning.

If you have any questions about our Proning Policy please contact Chief Nurse, Paula Gardner directly.  Let’s not miss any more moments getting this right.

2. PPE – dates and openness

As indicated yesterday here, and covered in Toby’s Friday message tonight, not all of our masks are inside the date initially recommended by their manufacturer. That makes us the same as the whole country. So the masks we got from the national stockpile in March were in some cases after date, and had been reviewed for safety by Public Health England before issue. We re-reviewed them and they passed our safety tests. However, most of our masks, our Alphas, were not from that source and are still inside the dates on the boxes. They also pass our safety tests. Betafit masks were beyond date but also passed. If you do experience issues, it is more likely that the issue is one of fit, but we will work with you on a personal solution. If you have concerns because you are hearing this for the first time or have questions, please get in touch with Dinah Mclannahan or Paula Gardner. We are confident in the safety of the equipment provided.

3. Basic and mandatory training: The time is now

The importance of completing your mandatory training remains and now is an ideal time for some before we restore elective services and some corporate functions. A&E and maternity will get busier in the summer.  We expect all colleagues who were not compliant in 2019-20 to be fully compliant with all modules by 1 July, just six weeks away.

All courses can now be supported virtually.  Most courses can be completed online. The few courses that were face to face are now being delivered via webex (eg Safeguarding) or a video (Local Fire Training). Basic Life Support (BLS) assessments can be done in a safe, socially distanced way.

For details on how to complete your mandatory training please go to https://connect2.swbh.nhs.uk/learning-development/mandatory-list/

4. Our Wellbeing Sanctuary: Take time for you

Your health and wellbeing remains paramount which is why we have recently opened our COVID-19 wellbeing sanctuary based at The Learning Works, Unett Street, Smethwick. The Sanctuary is accessible to all collagues and offers a range of health and wellbeing activities for colleagues. You can also pop in for a coffee and chat, or just to relax. 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.

Sessions last between 20 and 40 minutes. See the full timetable here and you can book a session by calling 0121 507 5886.

5. Revitalised services spring back to life at Birmingham’s Treatment Centre

With a focus on getting routine surgery and services back up and running, our Birmingham Treatment Centre has sprung back to life this week. Patients and you can attend safe in the knowledge that they are in clean surroundings.

On Tuesday theatres in the BTC reopen to provide surgical services.

The BTC is the first step in our journey to reopening, recovering and restarting services for our patients. If you work in the BTC or need to go there, please make sure you follow the new procedures in place. Entry is through a single point, and everyone must stop, sanitise and replace any PPE they may be wearing to ensure the BTC remains Covid free.

Chief Executive’s Message – Friday 15 May

This week has seen not one but two celebrations of disciplines in our Trust, with ODP day on Thursday, and International Nurses’ Day on May 12^th.  I know that there were all sorts of cake sales, and songs, and commemorations across our sites, and in community teams as well.  At a time when clapping and words like heroes are widely used, these days are in fact an opportunity to celebrate peer esteem.  The credit from our patients and communities matters, but these days are a chance for colleagues to say to theatre staff and to the whole nursing family – thank you.

Next week is Mental Health Awareness week across the UK.  This year the nominated theme is Kindness.  Kindness has also been the aim we set in developing our response to Covid-19 through Operation Mary Seacole.  Next week then is an ideal time to consider whether the sanctuary is for you – I have had wonderful feedback this week from people who visited it at the Learning Works near Midland Met.  Or a chance to log onto the Recharge Booth for 20 minutes on a Thursday.  We share a story, talk about it, provide a little space to breathe and make sure feelings are voiced and shared and understood.  Thank you to all who came forward as mental health first aiders – we will need your help in the weeks and months ahead.  In ten days’ time, at the Clinical Leadership Executive, we turn our attention to how we develop broader and more accessible psychological support for our patients, recognising the need to look after the whole of someone, and support them with their beliefs and behaviours, as well as with curative treatments.  I very much hope that Covid-19 has created a lasting acceptability to talking openly about mental wellbeing at work.  Of course, often in traumatic situations the impact can felt by you from things going on at home, or by those you live with from your experiences.  We are finalising a proposal for a support service to help address family members’ mental wellbeing this year and next.

Openness remains too at the heart of how we are trying to address the pandemic.  Next Friday we will hold a review meeting with senior staff from Black and Minority Ethnic backgrounds to look through the evidence and risk assessments to consider how best we approach staffing arrangements during June, July and August.  It is already the case that any colleague from a BAME background can request, and indeed insist, on a new risk assessment of their work status either through HR on 3116 or direct to me as sponsor of our BME staff network.  David Carruthers and I will be hosting the forthcoming session to co-design with colleagues what approach we need to take, as we move into a time where we are both managing Covid-19 and implementing the Restoration Plan to re-open some services in May, some services in June, and most services in July.

I want to thank any of you who have, since the outset of Covid-19, spoken up, or raised concerns and questions.  I believe we have a culture where that is possible and encouraged without reproach.  I have had a flurry of concerns voiced to me this week about Personal Protective Equipment (PPE).  As you know from Mark Anderson’s videos, putting on and taking off, handwashing and wider infection control is at least as important as masks.  However, this is both/and not either/or.  We have broadly two streams of PPE – nationally purchased and locally sourced.  The locally sourced is the alpha stream.  Those masks are generally well regarded by you (and inside date) bar one box of Beta-fit masks, which had an expired date and were therefore re-tested for filter quality and passed.   You will know that the national stockpile contained past use by date masks issued in March, and a review by Public Health England confirmed their fitness for use despite some expired dates.  We undertook our own review on arrival here of the FFP3 and they passed our tests as well.  Accordingly, if you have used one and have experienced concerns, we will work with you on the fit.  Whilst I understand expiry dates are a salient thing on the side of the box, we set our store by the testing of the masks that we have done.  Please do contact Dinah, Paula or myself if you have specific questions or queries.

Pictured is our Star of the Week, Beata.  I remember meeting her at the outset of Operation Mary Seacole down at Leasowes.  We talked about how the centre was changing to become our end of life care hub, why we were changing and what that meant, both for patients and their loved ones, and for our teams.  The service supported by a local GP practice, and has gone from having two palliative care beds to over 20 rooms.  Our vision was that, allied to our Outstanding rated End of Life Care service we would seek to create as positive an environment as possible for those we are caring for, with as much personalised care as social distance allows, in a calm and suitable environment.  We will be reviewing in June how the changes have gone as part of what-next with Restoration.  The families of those we have looked after, and the teams involved, will play a part in that review.  We very much want to be able to set out what the future looks like for these services, remembering that in our 2020 Quality Plan we set some ambitious goals about choice and dignity at end of life.  They remain our aims.

You may  be reading that last paragraph having looked after someone isolated from their loved ones in their final days.  Some of the hardest and most heart rending stories to date from this situation have been just that.  I know you are working hard to find ways to connect patients with their loved ones, by video, or by selected visiting.  Bearing in mind the lockdown and test/trace position, we are keeping under constant review our visiting policies in this domain.  The Board on June 4^th is examining the subject, under Tammy Davies’ leadership, and discussing family stories from some of the deaths that have taken place in our care.  I expect to be able to set out the way ahead thereafter.  Thank you to Kulwinder Johal and the team in our mortuary and bereavement services for all the work you have done during Covid-19, and thanks too from the local Muslim Burial Council whose gratitude for the compassion of that work has been shared with you but should be acknowledged here.

Much is ‘up in the air’ right.  Part way between school re-opening, hairdressers still shut, SPA time paused, QIHDs proceeding, scans starting in the Treatment Centre, but other services still off-site.  One group for whom those dilemmas are very real is to the over 400 of our colleagues at home, some shielding and others working at home.  Yesterday over 250 people joined us in a webex to explore their experiences of that, and talk about the future of home-based working.  I was delighted that most reported improved wellbeing and many that they felt properly connected to the Trust at a distance.  I am conscious that this was a temporary move, and that many of those working from home right now have worked on site for some time and have the advantage of knowing colleagues and systems.  On May 27^th we will revise our WFH to cover the period to the end of July, and over the next fortnight we have sharp work to do with our health and safety team to look across all our office environments (in the first instance) and test them against new national guidance.  I expect our next guidance will be more directive about who does and does not work from home and more assertive in ensuring those who do have the kit and support they need.  Then in June we plan to launch our three year home working plans to build on what has been learnt in the last ten weeks, conscious that spaces like the Midland Met are hot-desk only.

So, without rushing, we want to seize a moment.  For many who have worked from home, losing the commute is no hardship.  And cars pile back on the roads that sense deepens.  I was delighted that our non-executive director, and local council cabinet member in Birmingham Waseem Zaffar, has launched the Emergency Birmingham Transport Plan.  Health, and this trust, are at the heart of that plan with its new cycle options to city hospital, renovation of the Dudley road, and implication about how we extend those projects to the University Hospital ready for 2022.  With the sun out, please do look again at your travel options, as I am, and think about what place cycling, or with future law changes, e-scooters, could offer you as a healthy, and safe, mode of travel just some of the week.  A note of possibility, not optimism, as all of us think about the future, and make sure in the present that we have space, time, and support to consider our best mental wellbeing at work and at home.

#hellomynameisToby

Essential IT infrastructure maintenance taking place tonight

Essential IT infrastructure maintenance will be taking place tonight from 9pm through to 2am where servers will be systematically rebooted one by one.

Unity and other clinical systems will remain online and operational throughout this period, however colleagues may find that their shared drive may become temporarily unavailable for a short period of time.

All services should be operating as normal as soon as the maintenance is complete at 2am.

If you experience any issues with Unity during this maintenance period that affect your ability to continue using the system, please ensure you  escalate to your line manager who will in turn inform the Duty Manager.

If you have any queries please contact the IT Service Desk on Ext. 4050. The service desk is available 24 hours a day, seven days a week.

Apologies for any inconvenience this may cause.

Working from Home Staff Briefing

A WebEx staff briefing took place yesterday focusing on colleagues who are currently working from home. If you didn’t manage to login to the session but you would like to catch up on the discussions you can watch a recording of the session below as well as finding the powerpoint presentation attached.

Heartbeat: Is it a bird? Is it a plane? No, it’s a CT scanner

The imaging team at City Hospital recently played host to an army of high-vis clad engineers from Siemens Healthineers who delivered the newest addition to the imaging department at the Birmingham Treatment Centre (BTC), the new computerised tomography (CT) scanner.

Amongst the beeping fanfare of a crane, engineers carefully peeled away the side wall of the BTC, constructed a reinforced platform and gently lifted, manoeuvred and landed the huge scanner onto the first floor to then be delicately pushed to its new home in the imaging department. CT scanners are innovative scanners that create cross sectional images of the body by rotating an x-ray machine round the body and then use a computer to reconstruct the multiple images into a single three-dimensional image that lets doctors look inside the body. Commonly, CT scanners diagnose infections, fractures and muscle disorders, as well as helping to pinpoint masses and tumours. They are sometimes even used to help guide surgical procedures and biopsies.

To find out more about the scanner, Heartbeat caught up with Phil Spencer, Superintendent Radiographer and CT Lead at our Trust. He said, “The newest scanner we have had delivered is now the fifth CT scanner we have at our disposal. We have two at Sandwell and three at City. This gives us plenty of resources offer imaging support at short notice, as well as resilience, should one of the scanners need to be repaired.”

Heartbeat: Trust bowel-ed over by national cancer audit results

The National Bowel Cancer Audit publishes results about the care and outcomes of patients with bowel cancer in England and Wales. Commissioned by the Healthcare Quality Improvement Partnership as part of the National Clinical Audit and Patient Outcomes Programme, this quality improvement programme has been running for several years. It is delivered jointly by the Clinical Effectiveness Unit at the Royal College of Surgeons of England, NHS Digital, and the Association of Coloproctology of Great Britain and Ireland.

Each year, a report is produced for trusts in England and multidisciplinary teams in Wales. Our most recent results published for 2017-2018 show that we included more patients than expected and we performed positively in several areas.

Mr Torrance, Colorectal Consultant remarked, “Our data collection is significantly better than it has been in the past and that has allowed us to share that we are performing above average compared to our local peers and nationally in most measures. We stood out in the rate of major surgery performed in potentially curative patients. Whilst the national score was 86 per cent, we scored 92 per cent – 6 per cent above the national average.

We also perform significantly more cases through keyhole surgery compared to the rest of the country, with 89 per cent attempted through keyhole surgery compared to 69 per cent nationally. When we combined this with our enhanced recovery programme supported by our anaesthetic colleagues, ward staff and clinical nurse specialist team, we have helped nearly half of patients go home within 5 days of major surgery compared to the national average of just over a third of patients.”

When discussing how we’ve achieved these results, Dr Torrance commented, “We have invested in our data and wanted to show just how well we’re performing as a Trust. We now have a dedicated person responsible for managing our data. Tahira Sani from our cancer services team has done a great job at collating all of our data and allowing us to show just how well we’re performing, both regionally and nationally.”

Speaking to Heartbeat, Tahira commented, “I have taken on the task of compiling our clinical data. This involves collating data from lots of different sources including systems and meeting notes. I was pleased to see how well we performed as a Trust in comparison to others locally and nationally.”

Heartbeat is online now

April edition of Heartbeat is now online! You can read the latest news from around the Trust on Connect. Find out about our fight back against COVID-19 and read some of our inspirational survivor stories.

COVID-19 Bulletin: Thursday 14 May

This is our every-day bulletin. Please use this bulletin and cascade arrangements within care and corporate groups to guide your actions. Throughout May 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.

A number of staff have raised queries about use-by dates on some equipment. Tomorrow afternoon we will have completed our review of the Trust’s stock and practice and will issue a clear summary of the position, both for equipment we have purchased, and for equipment received from national supplies.  Transparency is very important to us and we will be open with you.  At time of writing we are very satisfied with the safety of the equipment we have.

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

1. The Recharge Booth launched today!

The Recharge Booth is a ‘virtual’ space that allows you to come together with others, reflect, recharge, decompress, and join a safe and confidential discussion. The booth this week will be hosted by Richard Burnell and will focus on the feelings and emotions that are experienced during our daily work, rather than trying to find solutions.

The Recharge Booth will ‘open’ virtually and will run every Thursday at the same time (2pm). Each week we will be sharing different colleagues’ stories and experiences.

By joining the Recharge Booth, we hope that colleagues will feel better enabled to maintain their health and wellbeing, and that it helps to support resilience in both personal and working lives.

For more information please contact Richard Burnell on 07747 144874 or Claire Hubbard on 07866 004575.  If you would like to be part of the Recharge Booth, drop an email to swbh.rechargebooth@nhs.net.  A WebEx invite will be sent to your outlook diary, and you will simply need to click on the ‘join’ button to enter.

2. Sampling for COVID-19 – Changes to swabbing process

As the demand for COVID testing has increased, it has become evident that there are emerging issues with supplies of reagents in some laboratories. Therefore in an effort to ensure we are able to continue testing and reporting on COVID-19 results in a timely manner, we have decided today to move our COVID-19 testing to a new laboratory for a few days.

The new move means that we are no longer asking colleagues to use dry black swabs to take samples, but to move to using white oropharyngeal swab kits for the time being until supplies of reagent are restored.

Further details of the new process to take swabs is available in the attached poster. Please ensure this process is followed carefully as failure to do so will result in samples being rejected and discarded.

3. Red wards – the future plans

Since the start of the pandemic, we have organised our wards, and other areas, into red zones, and then wards, and blue wards.  Recently we added lilac wards for patients who had been in a red environment but were not confidently Covid-free.  From having over 250 covid patients our numbers have reduced by two thirds.  There are of course other patients waiting for swab results, or who have a negative test but clinical judgement remains that that person is likely Covid+.

Over the next few days we will be moving to fewer red wards in the Trust, converting some of those beds to lilac spaces.  We need to be ready to scale “back up”.  We also need to determine future staffing arrangements both for red and non-red areas.  Bear with us over the next 72 hours while we finish work to make those decisions on our ward structures from June to September.

4. Social distancing – Looking after your wellbeing

Social distancing doesn’t only apply when you are standing in the queue of a supermarket or getting your lunch, social distancing is now a way of life as we manage our response to COVID-19. Make sure this is observed whatever you are doing during this evening’s Clap for Carers.

Remember the two metre rule, whether you work in an office or a ward, you should be taking steps to limit close contact with colleagues, make good use of the available spaces and technologies we have available and keep yourself safe and well.

Next week the Trust starts work to examine our estate to make sure that office spaces and other communal areas comply fully with the guidance published yesterday by Government on safe working spaces.

5. Work from home – next steps

We held our webex today discussing future working from home patterns, to learn from those who have been working this way for a few weeks.  Thank you to everyone who took part.  Over 400 colleagues have filled out our survey on what has worked and not worked during lockdown and more than 250 took part today.

Toby Lewis confirmed that next steps now are in two phases:

• Revised WFH Guidance (v3) on May 27^th to cover the period to the end of July 2020,
• and launch in June of our 2020-2023 working from home plans.

Look out for the revised guidance, and space to talk in Team Talk this month about some of the principles which will sit behind our longer term home working model.  It is really important that we make it simple and rewarding to work from home, fair on those who do, and those who don’t – and we support people managing those who WFH.  PDRs can be done by WebEx!

Adding to wider the range of mental health support available, our colleagues at the Black Country Healthcare NHS Foundation Trust have set up 24/7 mental health helpline.  If you, or anyone you know within the region feels unable to cope and needs to speak to someone urgently you can do so by calling 0345 646 0827, pressing option 1 if you or they reside in Sandwell or Wolverhamption and option 2 for Dudley or Walsall.

Drug safety notice: Diazepam

We are currently experiencing a long-term shortage of Diazepam (Diazemuls) 10mg/2ml emulsion for injection. An anticipated resupply date has not been confirmed but is expected after September. Unlicensed imports are not available. Recommended clinical alternatives are available however there are insufficient quantities of lorazepam 4mg/ml injection (Ativan) to meet additional demand to cover the supply issue of Diazemuls.

Please see Diazepam sheet for further details.

For more information please contact the pharmacy department (City ext. 5263, Sandwell ext. 3783).

Working from home WebEx today

A special WebEx to hear from people who have been working from home is taking place today (Thursday 14 May) at 2.30pm.

Visit: https://swbhnhsevents.webex.com/swbhnhsevents/onstage/g.php?MTID=ece1a91f23682a8cbe9f39af46f2936a4 to join.

The meeting password is SWBWFH.

If you have any questions about how you join the briefing, contact subtan.mahmood@nhs.net.