Monthly archives: June 2020

Essential maintenance affecting Alfresco: Wednesday 10 June – 7pm

Please be aware essential maintenance is taking place today (Wednesday 10 June) affecting Alfresco. The work is scheduled to begin at 7pm and should be completed by 10pm.

During this time for up to 3 hours access to Scanned Clinical Patient notes will not be available in Unity/CSS.

We apologise for any inconvenience this may cause.

Should you have any queries on this please contact the IT helpdesk on ext 4050

Unity tip of the week: Getting rid of empty rows in assessments/fluid balance

This week’s tip of the week comes from Viraj Shah, Anaesthetics ST4:

“Get rid of empty rows in Assessments/Fluid Balance by unclicking ‘Show Empty Columns/Rows’ in Options (which will default this selection) or manually by clicking on the  icon.”

We are encouraging colleagues at all levels across the Trust to suggest any quick wins or top tips they have for using Unity in their ward, area or department.

All suggestions are welcome so please get in touch! The best suggestions will be featured in our Unity Tip of the Week every Wednesday on Connect.

If you have a tip of the week please send it to swbh.unitytips@nhs.net.

Heartbeat: R&D – Leading the way to innovations in COVID-19

The strong research and development culture at our Trust has once again come to the forefront as out R&D team has stepped forward and stepped up our involvement in a range of research trials looking in to COVID-19.

With innovation and ideas flowing from clinicians across the world, all with the aim of tackling COVID-19 and stopping it in its tracks, research trials have stepped up pace and nowhere more evident is that than our own Trust where to date, we have already managed to recruit over 63 patients in to a range of studies.

To find out more about the work of R&D in COVID-19, Heartbeat caught up with Gina Dutton, Head of Research and Development, she said, “Our Trust is proud of its long track record of excellence in clinical research and we’re keen to use all of our knowledge and ability to develop more effective ways of looking after our patients. COVID-19 has undoubtedly had a significant impact on both patients and healthcare professionals and it’s an ideal opportunity to support research in to innovations in treatment and care of COVID-19 patients.

“The portfolio of COVID-19 studies is increasing rapidly and I am proud to say that we have already opened or have in set up six of the most important COVID-19 clinical trials and observational studies, completing local governance checks and set up processes in record time. Key to this has been our close working relationship with the trials pharmacy team. This has been a whole Trust effort with all colleagues in various medical specialties pulling together to ensure that patients are offered these studies during their hospital stay.”

Shortly after it was announced that the prestigious RECOVERY trial had nationally recruited its 5000th participant, the Trust recruited its 50th. This study is looking at a range of drug treatment options for patients who are admitted to hospital with COVID-19. It is a rapidly changing study so that it can assess a range of treatments quickly. The current medications in the study include Lopinavir-Ritonavir, a commonly used HIV drug, Low-dose Dexamethasone – a type of steroid, which is used in a range of conditions typically to reduce inflammation, Hydroxychloroquine (anti-malarial drug), Azithromycin (antibiotic) and Tocilizumab (an anti-inflammatory treatment).

Two other treatment trials are for patients who are more poorly; REMAP-CAP is a drug trial using similar treatments to RECOVERY and RECOVERY RS: Respiratory Support is looking at different types of breathing support, continuous positive airway pressure (CPAP) and High flow nasal oxygen (HFNO). A fourth treatment trial, PRINCIPLE, is in set up with our GP colleagues in Your Health Partnership.

Two other studies are collecting data and samples to improve the understanding of genetics of COVID-19 and how it impacts on patients.

Star Awards 2020: Patient Safety Award

Do you know an individual or team who has exhibited best practice in providing safe care, who has openly raised awareness of safety issues, championed transparency or introduced new ways of working to a service or treatment that has improved patient safety?

Nominate them for the Patient Safety 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 Sarah Oley.

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.

In loving memory of Victor Dinoo

Victor Dinoo sadly died at the end of May from COVID-19. He was a valued member of the Trust working as a senior staff nurse. He worked on D11 and also undertook a number of bank shifts across SWB. He had also worked at Heartlands Hospital in Birmingham and University Hospitals Birmingham.

As part of Victor’s funeral service on Thursday 11 June, he will be brought to City Hospital (via Aberdeen Street) at 9.45am where he will be for 10 minutes should any colleagues want to pay their respects.

All are warmly welcome, and please do spread the word to former colleagues who may not receive the news.

Heartbeat: PPE – Staying safe at work

Personal Protective Equipment, otherwise known as PPE has become one of the key talking points during the COVID-19 pandemic. As we learn more about how the virus is transmitted the PPE requirements have changed. This may have caused some confusion and anxiety amongst colleagues. It is important that colleagues understand the correct use of PPE to keep ourselves, patients and colleagues safe.

From FFP3 to N95 masks, gowns to gloves, the assortment of protective equipment has steadily morphed as we have learnt lessons from countries that have battled COVID-19 before us, and changed the way we work to protect ourselves, colleagues and patients.

Throughout this pandemic, from the initial preparation phase to where we are now, one thing has stood the test of time – that being the need to protect colleagues as an utmost priority. From supporting face mask fit testing across the organisation, where almost 5,000 colleagues now know exactly which masks to use to be able to safely care for patients with COVID-19, to ensuring that as a Trust we’re able to adapt our practices to be one step ahead of COVID-19.

To find out more about the work being done to protect colleagues and patients, Heartbeat caught up with Infection Control Lead Nurse, Julie Booth. She said: “We know we need to protect colleagues to be able to continue caring for our patients safely, so it’s important we have the right support in place. We have been working hard to ensure that we’re able to reinforce not only our practices but our provisions to protect staff.

“Colleagues will no doubt have seen all of the posters that have been put up highlighting the red and blue areas as well as top to toe guidance on PPE. We now also have stations on the entrances to every ward area with clear guidance and supplies of PPE and we’re working with colleagues in supplies to ensure that we’re able to keep colleagues protected should there be any further changes to the guidance.”

Colleagues must remember to wash their hands, this is the most important thing that everyone must do regularly alongside ensuring that they are wearing the correct PPE appropriate to the right environment and patient contact. Remember that not everyone in a given ward or department will wear the same; there are differences due to the procedures that each person carries out that dictate the level of PPE.

Blood transfusions: Cross matched blood – message from Dr Shivan Pancham

Due to a laboratory issue the procedure to cross match blood will take  longer. It will  take at least an hour to provide cross matched blood from the receipt of the sample in the laboratory. The issue is being addressed but is likely to be a few weeks. We will update you when the situation improves.

These measures are to avoid ABO incompatible transfusions which is a never event. In an emergency, O negative units and Group specific blood is available.

How can you help? The principles of better blood transfusion are:

1.  Where possible plan transfusions during day time hours.
2. Any transfusions  at night should be for clinically urgent indications only

Please contact Dr Shivan Pancham, Haematology Consultant shivan.pancham@nhs.net  for any queries.

Star of the Week – Sharon Roberts

This week’s Star of the Week goes to Sharon Roberts, Patient Access Clerk.

Sharon has been tirelessly contacting patients this last week to reassure them they have not been forgotten and letting them know we will be in contact shortly when we know what is happening with services starting up again.

To some patients this has not just been a courtesy call but a call that has given the patient some time to talk to someone about random subjects as some patients haven’t had contact with anyone since the beginning of the pandemic which can make the patient become lonely.

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.

COVID-19 Bulletin: Friday 5 June

This is our last daily bulletin. Next week we will send out a once 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.

The R rate remains high. We continue to look after many people with COVID-19.  80% of our staff do not have antibodies. Changes in societal lockdown create new conditions to be managed.  So changing the bulletin does not reflect less risk.  What it reflects is that the story is not going to change.  There are not five messages every seven days.  There is the same message all week:  Thank you for your hard work, we have to stay distant, we must wash our hands, it is ok to not be ok – and kindness matters most. 

Look out for the new bulletin and thanks for spreading the word and not the virus.

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

1. Risk assessments for colleagues now published 

We have finalised the new COVID-19 risk assessment tool for Trust staff. This covers assessment of the risk level within the current service / work setting as well as individual risks including gender, ethnicity, age and underlying health condition. The outcomes of that assessment lead to clear actions to reduce the risk of COVID-19 for individuals. You should undertake this risk assessment via Occupational Health if you consider you are in a higher risk group.  This can be organised by email on swbh.riskassessmentoh@nhs.net or via phone on 0121 507 3306. Read the risk assessment document here.

The Trust is determined to build on our successful work to prioritise workplace safety.  That is all protections stay in place but PPE is now truly personal.

2. Shielded patients – change to patient advice

A new letter is available for shielded patients that reflects updates to shielding advice. This letter should be used when communicating with patients you identify as having a high risk of a severe illness should they contract COVID-19, and therefore need adding to the Shielded Patient List. It provides advice on shielding up to 30 June, but also recognises that, with lower levels of the virus circulating in the community, people may choose to go outdoors providing social distancing is maintained. The letter and advice guidance for healthcare professionals are listed below:

• High Risk Patient Letter
• NHS Update on Shielding

Looking after shielded patients is hugely important in the weeks ahead. Changes in lockdown do not mean that everyone can behave in the same way and we need to support shielded residents who may be disturbed or confused by their place in the guidance.

3. Alerting Lymphopenia: Saving Lives

It is recognised that in some patients having a low lymphocyte count could be suggestive of COVID-19, so to make this easier to spot in Unity we have changed the title of the alert to Lymphopenia, from COVID-19.  Our physicians are thinking through this measure as a key indication of asymptomatic risk.

4. Guidance on awake proning: Saving lives

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.

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.

5. Process for approval of other paid work

During our pandemic response we took the exceptional decision to introduce a temporary ban on colleagues undertaking secondary paid work. This included private practice and agency work as well as other jobs. This restriction did not apply where a role at the Trust was itself a second or third role.

From today, 5 June, we are removing the ban but have introduced new authorisation arrangements so that any such paid work is registered and pre-approved, along with registration of any gifts, hospitality and conflicts of interest. You can read the arrangements here.

The email address to register other paid work and ask for endorsement is swbh.paidwork@nhs.net

Heartbeat: Junior doctors – life on the frontline

Our Trust has mobilised in a way and at a pace unknown to us before and everyone has a part to play. Colleagues from administrative functions, nurses to HCAs and of course, our medical teams, have all pulled together at this challenging time.

Our junior doctors are playing a particularly significant role in this pandemic. There is a mix of experience and levels of responsibility among them, with some just newly qualified to those with a decade of practical experience working in hospitals. With approximately 53,000 junior doctors practising in England alone, they make up a sizeable part of any NHS Trust, and in ours, they are crucial in our battle against COVID-19.

We caught up with Alison Eastaugh, Geriatric and Chief Medical Registrar, to find out what life on the frontline has been like for her. She told us: “I think at first anticipation and anxiety were common feelings among myself and my colleagues. There was a sense of the unknown, we weren’t sure how many patients we would see or how unwell they might be. Many of my colleagues were also being moved to other areas to provide support where they were most needed.”

Working through this pandemic has brought with it some unfamiliar challenges. “Wearing personal protection equipment (PPE) all day can be very uncomfortable. It also makes communication with colleagues and patients difficult. Breaking bad news to families on the telephone is also emotionally challenging.”

Speaking of the positives, Alison explained how working through this pandemic has brought a sense of camaraderie to the frontline.

“We have lots of junior doctors in our Trust; some of them at the beginning of their training, whilst others like me have several years’ experience. I am very overwhelmed and impressed by how we have come together, sharing best practice, looking after each other and learning how to tackle this pandemic. I feel particularly supported by the consultants – having that senior presence has been essential. Nurses, doctors, HCAs and ward services – we’ve all become closer as a team.”

Dr Sarah Faloon, CT2 Stroke Medicine, echoed these sentiments. She told us: “Working as a junior doctor during a global pandemic is not something I would have ever expected. I am amazed by how well everyone has pulled together and the willingness to volunteer into new and unfamiliar roles. Some of us have new responsibilities, for instance, myself and other core medical trainees have moved onto the medical registrar rota. Whilst initially daunting we have been so well supported by the consultants, other junior doctors and nursing staff.

“Morale and teamwork have been fantastic. Managing sick patients is what we are trained to do; however, the increased amount of end of life care and breaking bad news, especially when we have to do this over the telephone can be psychologically and emotionally demanding. The Trust and wellbeing team have looked after us by providing opportunities for debriefing and with their wellbeing campaign. I have been extremely moved by the public support, and I am very proud to work for the NHS as a medic here.”

Professor Jawad Khan, Director of Medical Education, told us how incredibly proud he is of our junior medical colleagues. Speaking to Heartbeat, he said: “I would like to draw particular attention to the resolve, determination and bravery of our junior medical staff in facing adversity at a time which has been physically and emotionally draining. The physical demands on us as doctors are substantial. Working, whilst wearing PPE, adds considerable effort in terms of caring for patients.

“The junior doctors have been pivotal in our efforts to address the surge in clinical demand. They are at the very forefront of our efforts, showing great flexibility when redeployed into new clinical environments, adapting to new roles and rotas. They have matured quickly, adjusted and remained steadfast to maintaining the highest standard of patient care. Their conduct has been exemplary. Their compassion and dedication cannot be overstated.”