Monthly archives: June 2020

Great work needs rewards…

Quality Improvement Half Days (QIHDs) were introduced in the Trust back in 2015, with the strap line  ‘Guaranteed time for teams to talk, listen, learn and act’. Since then, we have seen the number of multi professional teams grow and develop; focusing on quality conversations and introducing improvement and innovation. To show how each QIHD team is using their time, there is an accreditation programme that spans entry level all the way up to gold. Back in February all QIHD teams were asked to make sure that they had been accredited to entry level by the end of April 2020.

Within the past month six teams have achieved an increase in their accreditation level and have moved up the League Table, and we are seeing some great work come out of this protected time.

Achieving accreditation does not need to take long and will recognise the improvement work that is being undertaken in QIHD teams across the Trust. If you would like to know more about getting accreditation, please speak to or email Angharad Macgregor, angharad.macgregor@nhs.net for more information.

Congratulations to Trauma & Orthopaedics for becoming our second Gold team, joining Children’s Therapies at the top of the League Table.

City Hospital – Paediatric resus equipment for trolley’s moving to D30

With immediate effect from today (Friday 12 June), all paediatric equipment for the emergency trolleys at City Hospital will be located in the doctor’s office on ward D30.

For more information please contact rachel.andrews1@nhs.net.

Guidance on when and where to wear masks

We have reviewed our approach to mask wearing in different areas of the Trust, following recent government guidelines. Our local arrangements are:

• Non-clinical office buildings – colleagues should maintain social distancing and handwashing. There is no requirement to wear masks, however you may wear your own face covering if you choose.
• Clinical areas including wards, clinic rooms and imaging  – wear PPE as currently advised (Fluid-resistant surgical mask (FRSM), disposable gloves and apron in all clinical areas with visor/FFP3 for close clinical care/AGP).
• Communal areas in clinical buildings e.g. main entrances and corridors – ensure social distancing, there is no requirement to wear a mask unless it is not possible to be socially distanced. In this case then FRSMs should be worn.

See our overview here.

ECG tabs: Please ensure yours are in date

All colleagues are urged to ensure that any ECG tabs they are using are still moist and in date as this can lead to faults such as ECG machines not correctly picking up patient trace reliably.

For more information please contact garyhowse@nhs.net.

Have you read the latest, greatest edition of Heartbeat?

Welcome to the May edition of Heartbeat.

Get ready to read all the latest news, updates from your area and lots of good news stories that are guaranteed to bring a smile to your face. Whether you’re on your break, taking five or putting your feet up after a long day at work, please enjoy.

Want to know what’s in this month’s edition? Let’s take a sneak peek…

• Star Awards 2020 is open for your nominations! This is your chance to thank your colleagues and show just how much their amazing actions are appreciated.
• Discover our wellbeing sanctuary. It offers a range of services including massages, meditation, mindfulness and hypnosis.
• Read about our primary care study into COVID-19 that has been launched in the community.
• Take a look at the Shout Outs to see if you got a mention this month.
• Celebrate Serenity’s 10^th anniversary

Please let us know if you have an idea for an article. You can email the team at swbh.comms@nhs.net or call ext. 5303.

COVID-19 Bulletin: Wednesday 10 June

This is our weekly bulletin and will be issued every Wednesday. 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.

Numbers not statistics: Today’s totals (Friday 5 June’s totals)

1. Visiting inpatients – current restrictions remain

We have decided to keep our current visiting restrictions in place up to the end of June before making any changes. We are taking a cautionary approach to ensure that we can continue to minimise the risk of transmission of COVID-19. As a reminder, visiting inpatients is only permitted for one person at a time for patients who are at end of life and those with limited mental capacity, one parent/guardian of a child and birthing partners in maternity.

Please continue to encourage the use of mobile devices/tablets for families to keep in touch with their loved ones. We recognise the challenges that are faced by colleagues whilst implementing these restrictions and we want to thank everyone for their support in enforcing the current visiting arrangements.

2. Patient Pathway – When to test, transfer and treat in Red, Blue and Lilac

It is vital that our inpatients are placed in the right care environments (Red, Blue or Lilac wards/bays) and swabbed appropriately. Please ensure you read the linked Patient Swabbing Pathway which illustrates the points at which patients must be swabbed and how they will be supported through our services.

For the most up-to-date pathway, click here.

Remember:

• Any negative patient from a Red area MUST be moved to Lilac asap unless there is strong clinical presentation of COVID-19.
• Patients on Lilac wards MUST be swabbed every 3 days.
• Patients on Blue wards MUST be swabbed every 5 days.

For all patients who require a re-admission into hospital and re-attend via ED please follow the guidance below:

• All patients to be swabbed on admission to hospital regardless of when last swabbed.
• If a patient presents with COVID-19 symptoms but has had a negative swab, they are to be treated in the Red stream.
• If a patient presents and has a positive swab in the past 14 days – they are to be treated in the Red stream.

It is important the policy is applied as outlined in the pathway. That may vary from historic practice but it must be our standard approach.

3. Guidance on when and where to wear masks

We have reviewed our approach to mask wearing in different areas of the Trust, following recent government guidelines. Our local arrangements are:

• Non-clinical office buildings – colleagues should maintain social distancing and handwashing. There is no requirement to wear masks, however you may wear your own face covering if you choose.
• Clinical areas including wards, clinic rooms and imaging  – wear PPE as currently advised (Fluid-resistant surgical mask, disposable gloves and apron in all clinical areas with visor/FFP3 for close clinical care/AGP).
• Communal areas in clinical buildings e.g. main entrances and corridors – ensure social distancing, there is no requirement to wear a mask unless it is not possible to be socially distanced. In this case then FRSMs should be worn.

See our one page overview here.

4. NHS Test and Trace: What to do if you are contacted

The new NHS Test and Trace service has been in place for over and week and they are getting in touch with people who have been in contact with someone who has tested positive for COVID-19, under the following circumstances:

• Directly through physical contact, or be in such a position that you are in close proximity with a positive patient’s coughs/exhalations.
• Or, by proximity through extended closer contact.

If you are contacted by NHS Test and Trace or our own occupational health team who are doing contact tracing of cases within the Trust (e.g. a staff member with a COVID-19 positive swab result) you will be asked about your contact with others including whether there has been any breach of PPE during your contact with +COVID-19 patients. If contact has been identified you should:

• Book a COVID-19 swab test by calling 0121 507 2664 option 5.
• Review whether you have had contact with anyone not socially distanced or there has been a PPE breach in your working environment.
• Not attend work until you have the results of your test and are confirmed negative.
• Email the HR advice email address to advise that you are self-isolating and confirm that a swab has been booked – hradvice-for-covid-19@nhs.net.

Read more here.

5. Reflect and decompress this Thursday at the Recharge Booth

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. Hosted by Richard Burnell every Thursday at 2pm, the booth will be sharing stories from different colleagues over a 20-30 minute session.

This week the Recharge Booth will be focusing on the following story:

“I didn’t come into healthcare to be a hero. I came to try and make a difference and to help people. I am uncomfortable with people making us heroes and glorifying what we do. I don’t understand why I don’t like it, part of me thinks it’s because I feel the public have stood back and ignored the issues the NHS faced across the last few years and suddenly claim to love it; it feels a bit ‘two faced.’ Another part of me wonders why I can’t just appreciate the public realising the importance of the work we do and feel hopeful that things will change after this. It’s a strange feeling and one that I feel bad about having.”  

For more information please contact Richard Burnell on 07747 144874 or Claire Hubbard on 07866 004575.  Alternatively 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.

6. Mental wellbeing training

The Trust has launched its Level 1 mental wellbeing training which focuses on supporting colleagues through the COVID-19 pandemic and post-pandemic recovery. Part of the wellbeing support plan is the provision of training for all line managers, plus any volunteer colleagues, to have initial conversations with colleagues and, where appropriate, open the door to further services that may help. This is the Level 1 supervisor training which is in the form of e-learning material. Please follow the attached information on how to access the course.

e-Learning Registration – Level 1 Mental Wellbeing Supervisor Training

7.Antibody testing – make sure you book your test

Antibody testing is now available for ALL colleagues so make sure you book your appointment now. It’s a simple test which is to find out whether you have previously had Coronavirus and may have some degree of immunity.

From 22 June we will open up our services to partners from care homes, schools and social care – because we are one system. So grab your test chance now and make that call. Over 4,700 colleagues have been tested so far!

To book an appointment call 0121 507 6104 option 2. You can find out more in this questions and answers document. For more information please click here.

Heartbeat: Understanding more about COVID-19 – by David Carruthers

Since we first heard about this new virus the world has been trying to understand more about it….Who is most affected? How is it transmitted? Can you be immune to it? Why do some people have a mild illness and other cases end in a tragic outcome? What clinical interventions do patients respond to?

At our Trust, we are no exception to this hunger for information to understand COVID-19 so that we might best protect and treat patients who catch the virus.

We began seeing patients in our acute hospitals with potential coronavirus symptoms in February, but on testing, the initial query cases were negative. Our first confirmed case was at City Hospital on 12 March. We now have information on every patient who has been treated by us with a positive test result, every patient who has sadly died with COVID-19 and all those who we have seen and tested, whose test result came back clear.

We are undertaking our own data analysis on acute admissions to the Trust, contributing to national research projects (clinical, therapeutic and genetic) as well as detailed reviews of mortality data.

This information feeds into wider regional and national data analysis but even within our own Trust we can start to see patterns emerging – although it is important not to jump to conclusions. It is very evident that underlying health conditions contribute to the risk of more severe disease.

Age is a definite risk factor with 47 per cent of all COVID+ patients who have died in our hospitals being over 85 years old. Men seem to be affected more than women. Of the patients we have seen with COVID-19, 58 per cent have hypertension and 39 per cent have diabetes. This is higher for the patients who have died. We have also seen a difference over time since the start of the positive cases at our Trust. More of the patients who died were at City Hospital in March but this has changed in April, indicating the dynamic changing nature of the epidemic. When we have looked at ethnicity, there doesn’t appear to be a disproportionate impact on patients from different ethnic backgrounds at Sandwell Hospital, whereas in March, 39 per cent of the deaths of patients with COVID-19 at City Hospital were in black patients, but only 19 per cent in April which is line with the wider Birmingham population. This could indicate a geographical cluster in March in western Birmingham at the start of the outbreak.

We continue to collect and analyse this information as well as review deaths in our care whether covid-related or not. I am really pleased that our Trust is participating in several research studies on this virus as you can see elsewhere in Heartbeat.

The clinical care of patients in hospitals is also being reviewed carefully. The early provision of oxygen therapy, proning of patients (patients are placed on their front and the bed is tilted to relieve pressure on the lungs) and increased use of NIV/CPAP seems to be having a positive impact on some patients. We continue to share learning with other NHS organisations and see what has worked well in other parts of the world, modifying our approach to patient care as we learn more. Many thanks to all of you involved in patient care that makes rapid changes in our approach to management of COVID-19 possible.

Heartbeat: Caring for relatives during COVID-19 – by Paula Gardner

COVID-19 has changed the world as we know it in many ways, but one of the most significant ways that I see the impact, as a nurse, is the sheer challenge of relatives not being able to spend time with their loved ones who are in hospital. This goes against everything we nurses are used to and are comfortable with and has often left us stepping in more to provide that social contact and empathy that their relatives would normally bring.

Our patients remain at the forefront and at times, when we don’t see them, it can be easy to forget about the importance of regular communication with relatives. This is why we introduced our purple point telephone service two years ago – to allow visitors and patients to get on the spot help when they need it. It is certainly even more difficult to speak to relatives during the pandemic as they are not popping in as they used to. But it is precisely at this time that we need to consider more than ever how we talk to relatives about the care that the patient is receiving. We must all put ourselves in the shoes of those people whose anxiety must be heightened by the inability to visit and see how their friend or family member is getting on. I know, from speaking to relatives after their loved one has sadly passed away, just how traumatic the experience has been for them and how sad they are for not being able to spend as much time together as they wanted.

Our wards have tablets and phones to help people stay in touch. Yes, it might feel like it takes time to help people use these, but this time is essential in enabling patients to see their family and the absent family member to feel some closeness with their relative. This is

just as important as the hands on care we provide to every patient. Colleagues supporting patients in the community have the same struggles – whereas home visits still take place, some are replaced with a telephone call to check in and often the relative can feel excluded from this.

There are some great examples across the Trust of good, planned conversations with relatives. The critical care team have put together some excellent information for relatives that clearly sets out how they will communicate with them and gives them information on how to make contact virtually with patients. One of the key lessons we must learn throughout this pandemic is that careful, consistent communication with relatives is just as important as the care we give to our patients.

Star Awards 2020: Fundraiser of the Year

Do you know an individual or team either internally or externally who by their hard work, dedication and example, have made a significant difference by increasing the awareness of Your Trust Charity?

This can include achieving considerable and recognisable fundraising success and creating positive changes to service delivery. Showing good practice in the administration of charitable funds and demonstrating a true commitment to improving the fundraising capability of the charity (or charitable fund) or even collaborating with external facilitators to bring in good learning and pilot projects to our Trust.

Nominate them for the Fundraiser of the Year Award in this year’s upcoming Star Awards!

Ways to nominate:

• You can complete a paper nomination form which you can download by clicking here.
• You can send in a video nomination for free to swbh.comms@nhs.net via www.wetransfer.com Choose go to free. When doing the recording remember to state clearly who you are and the name of the person/team you are nominating.
• You can complete the online form by clicking here.

Be sure to check out this video featuring last year’s winner Sally Gutteridge.

If you have any questions regarding the Star Awards, please contact the communications team on 0121 507 5303 or email swbh.comms@nhs.net.

For more information, please visit our dedicated Star Awards page on Connect.

Carers Week

Carers Week is celebrated yearly and aims to raise awareness of caring, highlight the challenges unpaid carers face and recognise the contribution they make to families and communities thus drawing attention to the importance of the 6.5 million carers across the UK. It also helps people who don’t think of themselves as having caring responsibilities to identify as carers and access much-needed support.

For more information and to get involved in Carers Week please visit https://www.carersweek.org/get-involved