Monthly archives: November 2021

Pharmacy drug safety notices

We have three drug safety notices from our pharmacy department which clinical colleagues should be aware of. Please see information sheets below:

• NHS steroid emergency card memo
• Heparin (500 units) in sodium chloride 0.9% (500ml) infusion bags shortages
• Lidocaine 4 per cent ream shortages

For more information please contact the pharmacy department on ext. 5263/3783.

Chief Executive’s Message – Friday 19 November

My main plea today is for all of you to make time to complete your national NHS staff survey. There is only one week to go before the survey closes on Friday 26 November. If you have completed yours, thank you. If you are a line manager, please make sure that, over the next seven days, you create 15 minutes for each staff member in your team to do their survey and check to make sure they have done it. As a reminder, the emails come from survey@quality-health.co.uk and are titled “NHS Staff Survey 2021 Invitation: Sandwell and West Birmingham Hospitals NHS Trust”.

Some staff have had postal surveys so please ensure you fill it in and send it back in the freepost envelope. If you have any queries at all about what to do contact our comms teams swbh.comms@nhs.net who will be able to help.

It remains vital for us to hear from every colleague through these surveys. Without your input, we don’t know what things will make your working life better, and we are determined to improve how you feel about your job and working for this Trust. Your views do count and will make a difference to our future plans as we are making our people one of our three new strategic objectives.

Remember, there are still six £50 Love to Shop vouchers up for grabs in our prize draw for all those who complete a survey.

This week I had the opportunity to join leaders from across the Black Country and West Birmingham system in briefing local and regional media representatives on our plans to keep patients safe this winter, amidst the expected increasing number of patients requiring urgent and emergency care. At the same time, NHS Providers, the organisation who represents all NHS service organisations, announced their predictions that this winter would be the most challenging yet for the NHS, and leaders of ambulance Trusts published their report on the impact to patients of delayed hospital handovers. We are already experiencing significant pressure in many of our services which comes straight after our most difficult 18 months.

Working through these challenges can at times feel overwhelming and I know that many of you share my apprehensions about this coming winter. However, what came through clearly in our media briefing this week, was that every organisation has a significant number of schemes that are either operational right now or being worked up to help us do better for our patients and minimise the risks. And, we are working much better together as a whole system than ever before. What we can do jointly with other partners including primary care, social care and the voluntary sector will provide far more than we can offer on our own. And, what we can do together with partner Trusts, eliminating organisational boundaries, providing mutual support, will again help to keep our focus on how we keep patients safe.

There is a very clear message to all of us this winter that is the same for the general public. There are simple things we can and must all do to support yourselves and your loved ones:

• Get vaccinated for flu and COVID-19 and get your COVID-19 booster.  (I’ve had mine – have you?)
• Seek medical help when you need it, don’t wait until you become acutely unwell – there are a range of health services you can contact 24 hours a day for help. Go to 111.nhs.uk for all the information on what you can access locally
• Be mindful of infection prevention and control – get tested regularly, wash your hands thoroughly, wear the right PPE and be cautious when out and socialising

These measures will significantly impact the kind of winter we will experience and the demand for care and support.

Finally, thank you to everyone who is accommodating our new visiting arrangements that came into force on Wednesday. We are taking a cautious approach to opening up visiting and will continue to review regularly our visiting policy based on COVID-19 cases in hospitals, in the community and any outbreaks. But it is pleasing to be able to allow these short visits from loved ones who will undoubtedly appreciate the efforts you are all making to keep patients safe and yet allow this valued time for people to be together.

COVID-19 Bulletin: Friday 19 November

Numbers not statistics: This week (last week). 

*Numbers may decrease due to starters and leavers.

1. New: Chief Executive urges all to get jabbed and protected

We recently caught up with Richard Beeken, Chief Executive who is urging everyone – from colleagues to those in our community to get their COVID and flu vaccinations, if they haven’t already.

Be sure to check out this short message from our Richard below:

When and where to get your jabs:

Sandwell Hospital: Pop-up clinics for flu jabs are taking place on Tuesdays and Wednesdays throughout November and December in the main reception area between 9am-5pm. There are also pop-up clinics for both flu jabs and COVID boosters taking place in the Berridge Suite on 24 November, 2 and 16 December between 9am-4pm.

City Hospital:  Pop-up clinics for flu jabs are taking place at main entrance to City Hospital every Thursday and Friday throughout November and December between 9am-5pm.

The City vaccination hub in Sheldon Block is open seven days a week for flu jabs and COVID boosters between 8am-6pm for walk-ins. The hub is also open to the public for COVID boosters. The simply book system for staff vaccinations has now closed, but you can still book an appointment via the national booking system for City hub.

Rowley Regis Hospital: A pop-up clinic for flu jabs and COVID boosters is taking place in Westwood ward on Thursday 25 November between 9am-4pm.

Note: There must be at least six months (182 days) between your second dose of your COVID-19 jab and your booster.

Act now and be prepared for the months ahead. Visit a pop-up clinic to get your flu jab and COVID-19 booster. If you have any questions, you can contact the vaccine hub on 0121 507 4404.

2. New: Infection rates high in Rowley Regis

Colleagues are being advised that COVID-19 rates in Rowley Regis, particularly in the Rowley and Blackheath wards remain high.

Rowley Regis is made up of four council wards – Rowley, Blackheath, Cradley Heath and Old Hill and Tividale. These four wards are where confirmed cases of the virus are highest in Sandwell. In particular, case rates are highest in young people between the ages of 11 to 25.

The current weekly COVID-19 infection rate in the Rowley ward (519 per 100,000 people) is twice the average for Sandwell as a whole (261 per 1000,000 people).

In Blackheath the infection rate is 451 per 100,000 people.

In Rowley there is also a higher incidence of the AY.4.2 variant, compared to other Sandwell areas. This sub-variant is closely related to the Delta variant, which has been dominant in the UK for a while and is currently rising across the country.

We ask colleagues who live in these areas, or travel to them for work, to remain vigilant and continue to wear their masks and socially distance.

3. New: COVID and mental health webinar: 2 December

Black Country Healthcare NHS Foundation Trust are hosting a special COVID and mental health webinar on Thursday 2 December, 11am – 12.30pm. The webinar will have a host of  clinical experts from across NHS to provide an update on the pandemic, how to keep safe and better ways of looking after your mental health. There will be a Q&A opportunity to put questions forward to all the panel members.

For further details and to join, please click here.

4. New: Inpatient eligibility for Ronapreve treatment has now changed

Patients that are hospitalised for the management of COVID-19 and hospitalised patients with incidental/nosocomial COVID-19 can receive treatment. There are different doses for each cohort of patients, details can be found in the “nMABs in hospitalised patients” pathway or by clicking here.

Note: Patients in ED and AMU should all be tested for anti-spike (anti-S) antibodies against SARS-CoV-2. This can be done as an add-on test.

The treatment has been developed from the results of the RECOVERY trial. nMABs is proven to reduce the potential risk of serious illness and reduces the length of time patients spend in hospital receiving treatment for the management of COVID-19.

All pathways can be found on the Covid Clinical Guidance page.

5. Updated: Process for enabling visiting on some wards

Due to reports of a lack of consistency in enabling visitors to designated wards, we would like to clarify the process to safely enable some visiting to take place. The confusion appears to be in the process by which visitors prove they are negative of COVID-19 through a lateral flow test. We have updated our poster here to advise that visitors must prove either photographic evidence of a negative lateral flow test (done the same day they wish to visit) or provide evidence from the government website where they uploaded their results. The Trust cannot provide lateral flow tests or accommodate visitors who wish to do a lateral flow test on site.

Our new visiting restrictions allow inpatients in amber areas to receive one visitor for up to 30 minutes per day. Patients can nominate two individuals who can visit for the duration of their stay, ideally from the same household. Visitors must use hand sanitiser and wear a face mask on entry. They must also show evidence of a negative lateral flow test result taken that same day to be checked on entrance to the building. All visits must be booked in advance by telephoning the ward to allow wards to limit the number of visitors on a ward / bay at any one time. All visitors must be free of COVID-19 symptoms, and must not attend if they are a household contact of a COVID-19 positive case. We regret we are unable to allow visits by children (under 16 years) or those who are immunocompromised.

The established visiting arrangements for paediatrics, maternity, community wards and ICU remain in place with the addition of evidence of a negative lateral flow test result.

Visiting remains permissible in all areas for patients at end of life and to support patients who are distressed or need support with nutrition and hydration. Please talk to ward nurse in charge who can provide guidance about a visiting schedule.

Red and green areas, (D17, D21, D25, L2 and L3) where visiting is currently not allowed should ensure you have robust systems in place to communicate with relatives / next of kin and to support communication between patients and their loved ones.

 We will review visiting arrangements weekly based on a risk assessment taking into account COVID-19 case rates in the community, numbers of COVID-19 cases in our hospitals and any outbreaks.

6. Reminder: Celebrating Christmas safely

Christmas will soon be upon us and whilst we’re not going to take on the role of the Grinch, we do need to remind colleagues to please remain mindful that we are still operating in an uncertain time where COVID is still rife in the community and we are still battling to protect our patients.

For now our rules regarding masks, social distancing and limitation to visiting remain in place.

We want to be in a position where we can enjoy Christmas so there are a few basic rules we need to ensure we all follow when getting wards and departments trimmed up for Christmas:

• Christmas trees can be displayed
• All decorations and trees must be flame retardant
• All decorations, including lights, must be wipeable and cleaned before being displayed
• Decorations cannot be in any area where clinical procedures take place, e.g. bays/side rooms on wards
• Decorations should be limited to a single area on wards to ensure effective cleaning can take place
• Decorations attract dust – do not suspend them from walls and ceilings

If a ward is closed due to an outbreak of an infection, e.g. Norovirus, you must dispose of all decorations

And whilst our rules don’t apply out in the community, we ask that colleagues use their common sense and their skills as clinicians to avoid risky environments. Continue to wear masks when you’re indoors and in crowded spaces and remember to wash and sanitise your hands regularly.

For more details please see the Christmas information sheet. Any further queries should be directed to the IPC team on ext. 5195.

7. Reminder: Join the saliva testing programme to protect your patients and loved ones

Did you know saliva testing (known as LAMP – Loop Mediated Isothermal Amplification) is a speedy and less invasive way of detecting COVID-19?

You can book a kit collection slot for the weekly test, which requires you to spit into a tube in the morning before you brush your teeth or an hour after you have eaten.

When you arrive at work, you can deposit your sample into a red collection box. Many of these are positioned around our acute and community sites.

You can find drop off points and more information by clicking here.

If you are still unsure how to complete your LAMP test, be sure to check out the step-by-step guide in the video below.

Even if you are vaccinated it is vital that you register and carry out the weekly tests as they will help identify if you’re asymptomatic. Your saliva sample is ONLY used to test for COVID and is disposed of after testing.

The weekly saliva test is an easy way to help us all ensure we are remaining safe and playing our part in the battle against COVID-19.

Uptake of the weekly saliva test is monitored to ensure we are doing everything we can to protect our patients, the public and each other.

The latest data by group is below:

Antimicrobial Awareness Week – prevention is better than cure

Preventing the spread of organisms that cause healthcare-associated infections (HCAI) and ensuring optimal antimicrobial use is fundamentally important at our Trust.

Carbapenem-resistant gram-negative bacteria (CPE/CRE), multi drug resistant Acinetobacter baumannii and Pseudomonas aeruginosa are an emerging cause of healthcare acquired infection that poses a significant threat to public health.

‘Prevention is better than cure’ is the perfect phrase to highlight some of the simplest things you can do to support the fight against antimicrobial resistance. Hand washing is the simplest and most effective way of preventing healthcare associated infections which in turn will  reduce unnecessary use of antibiotics and transmission of antimicrobial-resistant bacteria.

The World Health Organisation is celebrating World Toilet Day today to raise awareness of the 3.6 billion people who are living without access modern safe sanitation. According to a recent survey only 19% of people wash their hands after using the toilet – putting themselves and those around them at significant risk of infection. Please remember hand hygiene is essential after using the toilet for patients, staff and visitors. Currently hand hygiene compliance is 98 per cent for our Trust.

During the World Antimicrobial Awareness Week, the IPC team will be doing commode checks to ensure that they are clean and safe for patients.

Surveillance of antibiotic resistance and monitoring of IPC practices are crucial in order to understand the trust specific issues and put in place appropriate preventive measures and develop tailored antimicrobial stewardship strategies.

• Hand hygiene compliance: The 5 WHO moments
• Practice related to the use of Personal Protective Equipment (PPE)
• Environmental cleaning compliance
• Compliance with indwelling devices and intravenous lines insertion and management
• Difficile rates
• Nosocomial / hospital acquired infection rates
• Compliance with the mandatory aseptic non-touch techniques

Adopting robust infection prevention and hand hygiene practices will prevent Antimicrobial resistance (AMR) and protect patients from multi drug resistant infections.

All colleagues at SWB have a responsibility to ensure they are compliant with and adhere to infection prevention and control policies, procedures and guidelines.

Be sure to check out this short video featuring Dr Chizo Agwu, Deputy Medical Director, pledging to raise awareness of antimicrobial resistance and promote best practice.

Antibiotics quiz: Be sure to have a go at our antibiotic quiz. The person who gets the most answers correct will be entered into a draw to win some Love2Shop vouchers. You can complete the quiz by clicking here.

Don’t miss out – have your say in the NHS Staff Survey!

There is only one week left to have your say in the national staff survey. Everyone in our workplace is being given the opportunity to take part.

• How motivated do you feel about coming to work?
• How safe do you think our organisation is?

You can tell us what you think about this and a lot more. All it takes is 15 minutes of your time.

You will have received an invitation to take part via email. Some colleagues will get paper surveys delivered directly to their home addresses.

Colleagues from communications and informatics will be visiting clinical areas to support the completion of the survey. Managers are urged to encourage and make arrangements for teams to share their views.

Do take the time to share your views. Senior managers will use the results to make improvements locally.

Julie Booth, Deputy Director for Infection Prevention and Control recently completed the survey as she believes in the importance of having your opinion and voice heard.

If you have any queries please email swbh.comms@nhs.net.

Managing our services this winter

We know that this winter will be particularly challenging due to COVID-19, a difficult flu season and more acutely unwell patients who had either delayed seeking medical help or had their treatment paused during the pandemic.

• We are working with colleagues across primary care, social care and the voluntary sector to respond to the increase in the number of patients who will need help this winter
• We are also working with neighbouring hospital Trusts to plan together and provide mutual support
• Our Clinical Leadership Executive have agreed to prioritise additional investment in schemes that help patients stay well at home, avoid admission to hospital and enable patients who are admitted to get home at the right time with the right support.

Additional schemes that we are aiming to set up this winter include:

• Extend opening hours of the Urgent Treatment Centres and GP support at both sites until midnight
• Additional support to all care homes in Sandwell
• Frailty services to help older, at risk people, stay well at home or respond quickly to those who come into hospital
• Seven day Single Point of Access services
• Increasing the layout and input into our same day emergency care services

We will also continue with essential services including the weekend discharge teams, seven day respiratory and cardiology admissions avoidance.

Review staffing and recruitment to wards that are needed now and over winter.

A big part of our planning is getting high rates of flu and COVID-19 vaccination. We must all play our part.

For further information contact Liam Kennedy or Johanne Newens.

Process for enabling visiting on some wards

Due to reports of a lack of consistency in enabling visitors to designated wards, we would like to clarify the process to safely enable some visiting to take place. The confusion appears to be in the process by which visitors prove they are negative of COVID-19 through a lateral flow test. We have updated our poster here to advise that visitors must prove either photographic evidence of a negative lateral flow test (done the same day they wish to visit) or provide evidence from the government website where they uploaded their results. The Trust cannot provide lateral flow tests or accommodate visitors who wish to do a lateral flow test on site.

Our new visiting restrictions allow inpatients in amber areas to receive one visitor for up to 30 minutes per day. Patients can nominate two individuals who can visit for the duration of their stay, ideally from the same household. Visitors must use hand sanitiser and wear a face mask on entry. They must also show evidence of a negative lateral flow test result taken that same day to be checked on entrance to the building. All visits must be booked in advance by telephoning the ward to allow wards to limit the number of visitors on a ward / bay at any one time. All visitors must be free of COVID-19 symptoms, and must not attend if they are a household contact of a COVID-19 positive case. We regret we are unable to allow visits by children (under 16 years) or those who are immunocompromised.

The established visiting arrangements for paediatrics, maternity, community wards and ICU remain in place with the addition of evidence of a negative lateral flow test result.

Visiting remains permissible in all areas for patients at end of life and to support patients who are distressed or need support with nutrition and hydration. Please talk to ward nurse in charge who can provide guidance about a visiting schedule.

Red and green areas, (D17, D21, D25, L2 and L3) where visiting is currently not allowed should ensure you have robust systems in place to communicate with relatives / next of kin and to support communication between patients and their loved ones.

We will review visiting arrangements weekly based on a risk assessment taking into account COVID-19 case rates in the community, numbers of COVID-19 cases in our hospitals and any outbreaks.

New visiting arrangements now in place

From today (17 November) we are easing our visiting restrictions to allow inpatients in amber areas to receive one visitor for up to 30 minutes per day. Patients can nominate two individuals who can visit for the duration of their stay, ideally from the same household. Visitors must use hand sanitiser and wear a face mask on entry. They must also show evidence of a negative lateral flow test result taken that same day to be checked on entrance to the building. All visits must be booked in advance by telephoning the ward to allow wards to limit the number of visitors on a ward / bay at any one time. All visitors must be free of COVID-19 symptoms, and must not attend if they are a household contact of a COVID-19 positive case. We regret we are unable to allow visits by children (under 16 years) or those who are immunocompromised.

For more information see the visiting information here.

The current visiting arrangements for paediatrics, maternity and ICU remain in place. Our usual exemptions apply for inpatient children, those at end of life and people who lack mental capacity.

Red and green areas, where visiting is currently not allowed, should ensure they have robust systems in place to support communication between patients and their loved ones.

We will review visiting arrangements weekly based on a risk assessment taking into account COVID-19 case rates in the community and numbers of COVID-19 cases in our hospitals.

Fraud Awareness Week: Email scam – NHS COVID support payments

We have been made aware of an email being shared directly with NHS staff offering access to a COVID relief fund of nearly £3m. These emails are being sent from genuine NHS.net email accounts that have been taken over by fraudsters. The link will take you to a log in page where you are asked to enter your personal details, including bank details.

The fund is a scam which has no link to the NHS. If you enter your username and password to a fake log in page the fraudsters will be able to access your email account and use this to commit further fraud.

Actions required:

1. Do not click on the links, and do not enter any of your personal information.
2. Hover your mouse over any links to view the actual file path to verify it is genuine.
3. Report the Spam email as per your organisations guidance and delete it.
4. Change your password as required by the IT team, and ensure a strong password is used.

All suspicions of fraud or bribery should be reported to the Local Counter Fraud Specialist Sophie Coster (Tel: 07436 268747), Chief Finance Officer Dinah McLannahan; or NHSCFA via 0800 028 40 60.

Notice Fraud November: In this November issue we focus on current fraud trends across the NHS, providing you with some useful insights into current fraud risk areas and details of some recent fraud investigations. Click here to check it out.

Spread awareness, stop resistance – join the fight against antimicrobial resistance

Today is European antibiotic awareness day and start of World Antimicrobial Awareness Week (WAAW) 18 to 24 November.

The week aims to increase awareness of global antimicrobial resistance (AMR) and to encourage best practices among the general public, health workers and policy makers to avoid  the further emergence and spread of drug-resistant infections.

The theme for WAAW 2021 is ‘Spread Awareness, Stop Resistance’

Antimicrobial resistance is one of the leading threats to human health and the practice of modern medicine. It is estimated that antimicrobial resistance could cause 10 million deaths a year by 2050. Increasing antibiotic resistance potentially threatens the safety and efficacy of surgical procedures and immunosuppressing chemotherapy leading to negative impact on patient outcomes such as prolonged morbidity, hospital stay, and increased risk of death.

The drug-resistant infections result from inappropriate prescribing and improper use of antibiotics mean that we’ve already seen a resurgence of infections which we had previous all but cured such as ESBL and Carbapenem-resistant Enterobacteriaceae (CPE) also other bacteria such as Staphylococcus aureus/MRSA, are rapidly becoming resistant to not just one type of antibiotic, but several types, including those of a last resort. It means people are starting to die of minor injuries or infections which previously we could treat such as skin infections after routine surgery.

Antibiotics are not an everlasting panacea for all illnesses – they don’t ever work against viruses and using them inappropriately drives antibiotic resistance and results in drug resistant infections which can’t be treated.

Antibiotic resistance is a bit like climate change – it’s a massive world-wide problem, caused by multiple factors associated with modern life – from the way we produce our food such as giving animals antibiotics when they are not needed, to the way we manage our environment and our expectations about our own health and wellbeing.

Antibiotics in clinical practice

Health professionals are encouraged to ensure a timely review of antibiotic course length, empiric prescribing, intravenous-oral switch, and promotion of current clinical guidelines.

Antimicrobial stewardship

Antimicrobial stewardship is a key component in the reduction of healthcare associated infections and contributes to slowing the development of antimicrobial resistance. A Start Smart, then Focus approach is recommended for all antimicrobial prescriptions

Antibiotic amnesty

As part of antimicrobial awareness week, we are promoting antibiotic amnesty aimed to encourage healthcare professionals to think about whether a patient really needs antibiotics. It also encourages people to return unused antibiotics and help combat antibiotic resistance.