Monthly archives: January 2021

Heartbeat: Forget me not – a memorial service with a difference

2020 is a year we will remember in lots of different ways, but perhaps it will one day be looked back on as the year that made us change almost every detail of our daily lives and how we do things. A year that made us change how we interact with each other, live, work, socialise, celebrate and mourn.

Critical care, like lots of areas in our organisation, has been impacted by the devastation of Coronavirus. Learning how to adapt has been the common thread that has seen areas triumph in the face of what has undoubtedly been one of our most challenging years

Annually, critical care hosts a memorial service. 2020 was the 15th annual memorial service – families and members of the critical care bereavement team were unable to gather together and, so they hosted a memorial service with a difference. Keen to ensure the memorial went ahead, the team set about creating an event that would still allow relatives and friends a chance to reflect and feel connected to those that looked after their loved ones.

As with previous years, the event involved the chaplaincy team. It was vital to have their input to reflect the multi-faith community that they serve. Catherine Beddowes, Senior Sister, told Heartbeat: “Each year we host a memorial service. It’s an integral part of what we do outside of our work on the wards. As you would expect, we deal with some of the most challenging medical cases and, it’s imperative to us that we continue to support family and friends in the aftermath of losing a loved one.

“We recognise that we look after patients of all faiths. That is why our service must be accessible to everyone. Mourning is a process and, as a team, we seek to help grieving family and friends recognise the impact of death and celebrate the lives of those they loved through our memorial service.”

On 29 November 2020, a remote memorial service took place. Based on the theme of forget me not, it incorporated lots of special touches. Importantly, family and friends stayed at home and received a bag of forget me not seeds that once sewn will flourish into a remembrance plant. A symbol of love and memories, this small but thoughtful gesture is a sign of just how much the team care about those they look after.

Each person was asked to light a candle at home to remember their loved one and our chaplaincy team did the same. Everyone also received a memorial booklet as well as a glass love heart to be hung in windows to reflect light kindly paid for by our organ donation committee.

Reverend Mary Causer told us: “So much of this year has been about finding new ways to do things. There was no doubt in our minds that we had to host our memorial service and so we worked collaboratively to design a safe way to help support grieving families at this difficult time.

“We produced a memorial booklet that had poems and a song inside. The words seemed even more poignant this year as we’ve had to deal with how we say goodbye to our loved ones in an altogether different way – Time for us to part now, we won’t say goodbye; Look for me in the rainbows, shining in the sky.”

Catherine echoed this sentiment: “COVID-19 has made the way families say goodbye change dramatically. For those that have wanted to visit, they have had limited time to spend with the people they love so dearly and, that’s hard for families.

“This is our way of showing we still care; we are still there for families even in these strange and testing times. We are doing the best we can and, this is our small way of helping families heal.”

Wellbeing snacks available for patients

As part of the Trust’s response to improve patient care, nutritional wellbeing snacks are available for patients on all wards at City, Sandwell, Rowley and Leasowes.

Did you also know that snacks, milky drinks and high calorie options can be added to a patient’s nutritional care plan on Unity if their MUST (malnutrition universal screening tool) scores 1 or above? 

The MUST is completed for every patient upon admission to identify those who are at risk of malnutrition and provides the appropriate nutritional intervention. For these high risk patients, snacks provide a welcome addition to help increase much needed calories.

If you have any questions, concerns or would like some further information regarding the nutrition support which is available please contact the dietitians on ext. 4486 (option 2).

Dry January – Support the team on Just Giving

2020 has been a challenging year for colleagues across the Trust so why not start 2021 by joining in with Dry January!

Dry January is the annual movement through which millions of people across the country make the pledge to give up alcohol from 1 January until the end of the month.

Taking part in Dry January is a chance to ditch the hangover, reduce your waistline, boost your energy and save some serious money, while doing your physical health a lot of good and also improving your overall mental health and wellbeing.

Longer term, there are far more health benefits that come from cutting back your alcohol consumption including the lowering of your blood pressure and cholesterol, and reducing the risk of diabetes and cancer related proteins in your blood.

If you’re taking part in Dry January this year the alcohol team have a Just Giving page where you can donate, share and be a part of Dry January. The funds raised will go towards a FibroScan van. FibroScans are specialised ultrasounds that can measure liver scarring and fatty changes. The van will enable us to promote alcohol reduction and prevent liver disease in the local community and in our Trust. Click here to find out more and visit the page!

Dry January Poster

COVID-19 Bulletin: Thursday 21 January

Numbers not statistics: This week (last week)

New:

• Revised PPE Guidance: Important update
• Misinformation and Mistrust – Don’t delay getting vaccinated
• Our NHS People Understanding different bereavement practices and how our colleagues may experience grief
• Confidently showing everything is clean

 Reminder:

• Supporting our colleagues

1. New: Revised PPE Guidance: Important update

We have carried out a further risk assessment in relation to PPE usage in our clinical areas. This has taken into account the current high volume of infection rates in the community, the corresponding high number of COVID-19 admissions, some cases where patients on amber non-COVID wards have subsequently had a positive Covid PCR swab test after initial negative test, and the ventilation in our ward areas. The outcome of that risk assessment has led to a decision to increase the required level of PPE in these inpatient environments for some staff. This is above and beyond  the current national guidelines.  This is  under constant review and may well change if the regular review of the risk assessment indicates  that the risk is lowered.

For all inpatient areas where there is direct patient contact (in red and amber wards), staff should wear

• Silicone mask /FFP3 mask , visor, these can be sessional use – single use gloves and aprons. (please ensure you have been fit tested for an FFP3 mask before use)
• You should wear a fluid-resistant surgical face mask if you do not have direct patient contact.  Non-direct patient contact includes walking on a ward area, pharmacists, clerical staff, estates and facilities staff. Disposable gloves / aprons should be worn for contact with patient / immediate environment. Porters who are transferring patients should wear FFP3 / silicone face mask when transferring patients to red / amber wards.
• If you are visiting the ward from another area, a minimum requirement when entering the unit will be to wear a fluid resistant surgical face mask

Please note: staff must follow their individual risk assessment for PPE, occasionally this will recommend a higher level of protection depending on your individual assessment.

For all Outpatients and Community staff inclusive of Health Visitors/School Nurses/GP practices, for staff visiting care home facilities, patients and families homes, surgical face masks and visors should be worn as a minimum with disposable apron and gloves for direct patient care. Consideration should be given to the clinical intervention which is being undertaken, and a clinical risk assessment should be undertaken in relation to this prior to the contact to establish whether there is a requirement for a higher level of PPE e.g. patient with known respiratory condition who has a persistent cough (not COVID related) then to wear an FFP3 and a visor in the event that the contact is essential and cannot be delayed.

Porters and facilities staff on wards can continue to wear a surgical face mask unless in direct patient contact and they will then need to follow the guidelines for inpatient staff above.

If you have any questions please speak to your line managers or infection control who will advise you.

2. New: Misinformation and Mistrust – Don’t delay getting vaccinated

Research recently released by the Scientific Advisory Group for Emergencies (SAGE) found that vaccine hesitancy was highest amongst Black or Black British groups with 72% stating that they were either unlikely or very unlikely to get the jab.

Fuelled by misinformation, mistrust and religious concerns, the high rates of Black and Minority Ethnic (BME) Groups declining the offer of a COVID-19 vaccination is definitely cause for concern.

Today we hear from Deputy Medical Director Chizo Agwu on why she got the vaccination and why she’s encouraging colleagues to step forward and get the lifesaving protection offered by the COVID-19 vaccination.

If you are yet to get your first dose of the vaccination contact the booking team on 0121 507 4112 to book into an available slot.

3. New: Our NHS People Understanding different bereavement practices and how our colleagues may experience grief

At home or at work, many of us are thinking through loved ones’ lost or deeply unwell.  It is really important to find space and scope to talk and think.

With support from a wide range of organisations, colleagues and staff networks, NHS England and NHS Improvement have developed a bereavement resource that recognises the diversity of our staff, and, together with a short supporting animation, intends to build upon existing managerial cultural competencies recognising the diversity of our staff. This resource will enable line managers to be able to confidently start conversations with staff who have experienced loss in a more compassionate way, as a result of gaining a deeper understanding of the different ways in which our colleagues may experience a bereavement, noting the varying practices different religions and cultures may follow.

4. New: Confidently showing everything is clean

COVID-19 has once again proven to us that spotlessly clean wards and attention to detail isn’t just something that we aim for but something that we must see as our standard. Every ward area should be spotlessly clean, every colleague should be seen to carefully wash their hands and every piece of equipment should be clearly identifiable as being clean.

When it comes to equipment on wards, there has always been a standing rule that everything must be sanitised after use, but how do you know when it is clean? Many of the germs, bacteria and virus are incredible small and can be spread without knowing. This is where our latest change in practice comes in to play with the roll out of our ‘I am clean’ stickers.

Colleagues no longer need to assume that equipment has been cleaned when they can now look to see if it carries a fresh ‘I am clean’ sign, showing not only that it has been sanitised but also when it was last sanitised.

As well as being helpful sign, the new stickers help build confidence in our practices and processes. When patients see a blood pressure monitor or even a commode being brought to them, they will be able to clearly see that it carries a sticker that shows it has been cleaned.

The stickers are also a very welcome sign to patients, a lot of work goes in to cleaning, sanitising and preparing every bed, bay, surface and piece of equipment in a ward, but the patients often have to assume this has all been done, the new stickers clearly show that someone has taken the time to clean and sanitise the equipment.

To find out more about the Infection Prevention and Control practices and programmes, contact ext. 5900.

5. Reminder: Supporting our colleagues

A range of guides have been developed by the NHS Leadership Academy to help support colleagues with skills and new ways to improve their experience of work. The guides cover topics such as personal resilience and support for line managers.

Topics available include:

• Managing with kindness civility and respect
• Personal resilience
• Making decisions under pressure
• Maintaining routine
• Leadership and wellbeing

You can access the guides on the following link: https://people.nhs.uk/

Finding the person behind the patient

Dr Mike Blaber SWBH Wellbeing junior doctor lead and speciality doctor in palliative medicine talking about the What, Why and Who behind providing great Spiritual Care, see his talk here

SWB cardiology academic series: Cardiovascular optimisation in pregnancy webinar

A cardiovascular optimisation in pregnancy webinar will be hosted by Dr Shamim Rahman on Friday 29 January, 5.45pm – 7pm.

For a detailed itinerary for the webinar please click here. 

To register for this digital event please click here.

For more information please email shamim.rahman@nhs.net.

NHSEI 2019/20 pensions annual allowance charge compensation policy

Clinicians who are members of the NHS Pension Scheme and who, as a result of work undertaken in the 2019/20 tax year face a tax charge in respect of the growth of their NHS Pension Scheme benefits above their pension savings annual allowance threshold, will be able to have this charge paid by the NHS pension scheme. Please see the information below:

NHSEI is encouraging clinicians in England who have received a pension savings statement or believe they may be subject to an annual allowance charge to work out if they have a charge to pay, and follow the steps outlined on the NHSEI website to apply for the 2019/20 pension annual allowance charge compensation policy (PAACCS).

To use scheme pays, clinicians must make an application using the scheme pays election (SPE2) form. This must be completed and returned to NHS pensions by the 31 July 2021 or before retirement or age 75, whichever is earlier. Clinicians and their employing authority will also need to complete an application form available on the NHSEI website to confirm their clinical eligibility.

Drug safety notice: Methylprednisolone injections

There is currently insufficient supply in the UK of all strengths of Methylprednisolone injections. We urge clinicians to review all patients on Methylprednisolone for acute respiratory distress syndrome in critically ill COVID-19 patients and switch to an alternative steroid.

Please see methylpred shortage information sheet for further details.

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

COVID-19 Bulletin: Wednesday 20 January

New:

• COVID-19 Vaccinations now open to all staff
• Cleaning for Confidence – Scrubbing up on your skills

 Reminder:

• Face masks – They’re not one size fits all
• Keeping everyone safe – Testing and isolation
• Recording COVID related absence on ESR

1. New –  COVID-19 Vaccinations now open to all staff

A testament to the hard work and determination of our vaccination team, we are now please to be able to offer the COVID-19 vaccination to all staff from the Sandwell hospital hub, regardless of role or risk assessed criteria.

Email invitations have now gone out to all remaining colleagues who were yet to receive their first dose of the vaccine, but if you haven’t spotted the message or you have mislaid it, you can book your vaccination by contacting the booking team on 0121 507 4112 to book into an available slot.

Please remember however that we are currently only offering the first dose of the vaccine. At your first vaccine appointment you will be booked for your second dose 12 weeks after the first dose has been administered, a time interval that there is no flexibility on. This is following national guidelines and is mirrored in all other Trusts, GPs and vaccination centres. The first dose offers good levels of protection and we can reduce transmission significantly in the community by giving more people the first dose and the second dose after 12 weeks.

2. New – Cleaning for Confidence – Scrubbing up on your skills

Keeping our sites safe and clean for patients is a commitment that we all share. It is something that has never been more important. Evidence shows that a range of actions such as wearing PPE, keeping our distance in and out of work, hand hygiene as well as clean sites will help to significantly reduce the spread of infection.

We know that colleagues have been working tirelessly throughout 2020 to keep essential services running. We also know that if PPE is not being worn correctly, social distancing is not maintained and cleaning best practice is not followed then it can contribute to outbreaks – which means we must go further to address this.

Coronavirus outbreaks within healthcare settings have been seen across the country – something that anecdotal evidence and academic studies alike suggest are impacting the public’s confidence when accessing the medical attention they need.

A programme of e-learning – ‘Cleaning for Confidence’ – has been developed to support staff in ‘scrubbing up’ on their knowledge of good cleaning practice, as well as helping to reinforce other actions that help to stop the spread of infection.

Colleagues are being asked to take the time to log in to the new training package that’s available through e Learning for Health

3. Reminder – Face masks – They’re not one size fits all

There’s more to face masks than you would think, it’s not simply a matter of grabbing the closest mask to you as you enter a ward, they only really work if they fit well.

For those of us who simply wear a fluid resistant surgical mask (FRSM), it’s just a matter of making sure you put it on the right way round (colour side outside) and to pinch the bridge of the nose to get it to fit. However if you need to wear an FFP3 mask or respirator, there is a whole range to choose from depending on the shape of your face, and you must be fit tested and assessed before you wear one in a clinical setting.

Colleagues MUST ensure that they have been fit tested for the current stock of face masks, this stock can change depending on availability so it’s important to keep an eye on comms for alerts about stock changes.

Under no circumstances should staff simply wear any mask they have at hand. Ill-fitting masks that allow particles to pass by the side of the masks leave the wearer at risk. You MUST be fit tested to be able to safely wear a face mask and be assured it is working properly.

To book yourself in for fit testing please call ext. 5050 and the team will book you into a slot at a site, date and time to suit you. Fit testing clinics are available everyday between 8am and 4pm. Additional capacity has been made available to respond to the changed requirements for fit-tested masks in amber, community and outpatient areas.

We expect to provide refined guidance on PPE tomorrow, following a number of queries received.

4. Reminder – Keeping everyone safe – Testing and isolation

Thank you to everyone who has been completing their Lateral Flow Tests and crucially, inputting their results online. Your results are strictly confidential and are never shared. However, the data provides us with really useful information about the spread of COVID-19 amongst staff so it’s incredibly important not only to carry out the test but to continue inputting your results online. A link can be found on Connect or you can click through from here.

 Remember, if your Lateral Flow test returns a positive you must self-isolate and alert your line manager immediately. You will be required to book in to complete a PCR swab test to confirm the results.

 Likewise, colleagues who have a household member who tests positive for COVID-19 must isolate immediately, even if they have returned negative Lateral Flow Test results. This is because there can be a time delay between contracting COVID and becoming contagious and the Lateral Flow Tests indicating a positive result.

5. Reminder – Recording COVID related absence on ESR

It is important to correctly record staff absence related to COVID-19 on ESR. This is to ensure that colleagues can receive the right support and to ensure that there are no discrepancies in pay.

The ESR team have produced some guidance showing the process for recording each type of absence.

You can view the full guidance by clicking here.

PPE guidance – are you fitted for a respirator?

Whilst most colleagues will be well accustomed to the disposable FFP3 masks but did you know that you could be fitted for and issued your own silicone respirator?

Silicone respirators are fit tested respirators that can be issued to colleagues who work in a role with direct patient contact. These respirators mean that you no longer need to worry about your particular fit of disposable mask being out of stock and you can carry on with your duties knowing that the respirator does not need a filter change for 3 months.

You get to keep your silicone respirator, it stays with you wherever you go and when you need it it’s there to be popped over your face. Just give it a thorough clean with a clinell wipe following our infection control and maintenance guidance and you are good to go.

To book yourself in for fit testing please call ext. 5050 and the team will book you into a slot at a site, date and time to suit you. Fit testing clinics are available everyday between 8am and 4pm. Additional capacity has been made available to respond to the changed requirements for fit-tested masks in amber, community and outpatient areas.

Please remember to wear eye protection also.

Note: If you are not in direct contact with a patient, then you may to continue to wear the fluid resistant surgical mask. If you are visiting the ward from another area, a minimum requirement when entering the unit will be to wear a fluid resistant surgical face mask.