Monthly archives: December 2022

Chief Executive’s Message – Friday 30 December

Jo Newens, Chief Operating Officer (Richard Beeken is away)

This is the final message of 2022, in a week that has seen us declare an internal critical incident due to the immense pressure on our services.

Thank you all for coming together and supporting each other to deliver the care our patients require in very challenging circumstances.

The safe discharges that we have managed to complete over the past few days have really made a huge impact on capacity and how we are managing the flow of our patients in hospital and into the community. Please continue to support patients with timely discharges – weigh up the pros and cons of our patients remaining in hospital and ensure you include patients and families in these discussions with a clear focus on what matters to them. We have excellent community teams who can support patients in their own home and in temporary community accommodation and these teams have full availability throughout the holiday period. How to access the out of hospital support is outlined in the communications bulletins should you need it.

The pressure this week has been exacerbated by an increase in flu and COVID cases. We introduced masks in clinical areas last week to help reduce transmission. We must remind you of the importance of following the correct infection and prevention control guidance. Wash your hands regularly, wear your masks, isolate when required and ensure your patients are screened in line with the guidelines.

You can help even further by ensuring you are vaccinated against flu and COVID to protect not just yourselves but loved ones and our patients too. We urge you to encourage your family and friends to get vaccinated. We are seeing the serious effects of flu with many patients becoming gravely ill with devastating consequences for some.

As we look to 2023, we need to recognise that the situation will remain challenging not just for our Trust and our Place colleagues but for the NHS as a whole. The NHS priorities and operational planning guidance 2023/24 which was published on the 23^rd December sets out the national direction of travel for the NHS as a whole. It recognises the excellent work that has taken place this year including eradicating two year waits for elective care and delivering record numbers of urgent cancer checks. It also acknowledges the continuing complexity and pressure we face and outlines three priority tasks:

• Recover our core services and productivity
• As we recover, make progress in delivering the key ambitions in the Long Term Plan
• Continue transforming the NHS for the future.

These are important tasks for the NHS, and as ever we will be working collaboratively with organisations in Birmingham and Solihull and the Black Country and West Birmingham Integrated Care systems to deliver the best outcomes for our local population.

Thank you for your continued efforts, let’s look forward to a successful year ahead. Happy 2023!

Message from pathology: Only use red or green top containers for flu testing

We must remind colleagues to not use the black topped dry swab for flu testing. Instead, either red or green topped containers which are used for COVID testing should be used for flu.

For further details please see red-green topped containers information sheet.

Opening times at the Education Centres during the festive period

Opening times for our education centres during the festive period are detailed below:

Education Centre, Sandwell:

• Friday 30 December – open for pre-booked meetings/training
• Monday 2 January – closed

Postgraduate Centre, City:

• Friday 30 December – Monday 2 January – closed

For more information please call ext. 3436 or email swb-tr.SWBH-GM-MEC-Reception@nhs.net and a member of the education team will be able to help with your enquiry.

welearn Wednesday: Reflecting and improvements made in response to incidents

Each month as part of welearn Wednesdays we present a new learning pack identified as a key learning topic from local serious incidents, investigations, complaints, litigation, or coroner cases. The learning may not have a direct link to your area of work; however, the learning provides an opportunity to reflect on some of the wider issues that could be useful for you to consider.

This month we are reflecting on learning, actions taken, and improvements made in response to incidents. Thank you to those individuals and teams that have supported this second half of 2022 with this new approach to themed learning. We look forward to evaluating this in 2023, progressing to be better, to seek better system and organisational learning to improve harm free care and better patient experiences

For more information please see welearn December newsletter.

If you would like to be involved in the welearn user reference group, please email marsha.jones3@nhs.net.

Staff isolation and when to return to work

The guidance for isolation and when to return to work for colleagues who have contracted COVID-19 has been revised.

Day 1 of isolation is the day after the colleague has developed symptoms, or if asymptomatic the date the positive LFT/PCR test was taken, whichever is earlier.

Colleagues can return to work from day 6 if they have had two negative lateral flow tests, feel clinically well and have a normal temperature. The LFTs should be taken 24 hours apart. The first LFT should not be taken before the day 4 and should ideally be taken as soon as possible on waking.

Further details of the clinic schedule can be found on Connect.

Inpatient screening for COVID-19 has also been updated. Positive COVID patients should be swabbed daily using LFT from day 4. If they have two consecutive negative results and no temperature, they can be stepped down from isolation.

Patients who are positive for flu can be stepped down from isolation on day 5 if they are asymptomatic. In rare occasions they can be stepped down on day 4 but this should only be done in agreement with the ward manager/clinical lead.  

Inpatient screening for COVID-19 has also been updated and can be found on the following link: Inpatient screening guide.

Critical Incident Stood Down: Thursday 29 December

1.Critical incident stood down

This morning we took the decision to stand down our critical incident status.

Thank you to colleagues who worked tirelessly to provide the best care possible under challenging circumstances over the last 24 hours.

Your efforts to support the safe discharge of patients and quick ambulance handovers mean we are now in a much-improved position, however we are on EMS Level 4 which means we are still managing extreme pressure.

Our command and control structures remain in place as they have been over the last few years. If you have any questions or concerns please raise these directly with your managers or tactical leads.

Please continue to support the range of actions listed below that are focussed on helping us to continue to safely manage the flow of patients within our hospitals and prevent us from having to instigate a critical incident.

2. Supporting patients with timely discharges

We need to work together to effectively balance risk and safety by means of continually reviewing the daily discharges. This requires your support and recognising a change of practice in these extreme times. Our ask of you is to weigh up the pros and cons of our patients remaining in hospital and including patients and families in these discussions with a clear focus on what matters to them.

When planning discharges please ensure you work closely with colleagues in pharmacy to ensure the TTOs are prepared in good time.

Colleagues in the Integrated Discharge Hub are also available to support you. Call them on extension 3147 or via  integrated.discharge-hub@nhs.net (open 8am – 8pm, 7 days per week).

Remember the discharge lounges are now open 7 days a week from 7am through to 7pm at Sandwell and City Hospital:

• Sandwell – Newton 1
• City – now on D28 (moved from AMU 1)

The lounges are the ideal location for patients who no longer meet the criteria to reside in our acute bedbase. Patients can be stepped down to the lounge whilst awaiting TTOs, transport or transfer to MFFD beds.

Please include the discharge lounge in your patient discharge discussions so they are aware of the journey.

Note: Where it is safe to do so, you may be requested to take an extra patient in your ward area.

3. Alternatives to emergency departments

As we continue to be busy across our emergency care services, so it’s important that patients are aware of the alternative ways to seek medical help.

This can be done by calling into their local pharmacy, dialling NHS 111, contacting their GP, or going to an urgent care centre.

We operate an Urgent Treatment Centre at Sandwell Hospital and patients at City are able to attend the Urgent Care Centre at Heath Street, in Birmingham. Most GP practices are also offering weekend access.

We would urge you to share this information with family and friends. Click here to see more

4. Influenza is on the rise – Understand the risk and protect yourself, your family and your patients

We are seeing a huge rise in the numbers of patients admitted to our hospitals with influenza, a highly contagious respiratory illness that can cause severe illness and even death, especially in vulnerable populations such as the elderly and those with underlying health conditions. As healthcare professionals, it is important to protect ourselves, our families, and our patients from the risks of influenza.

One of the best ways to prevent the spread of influenza is to get vaccinated. The flu vaccine is effective in reducing the risk of contracting and spreading the virus, and it is especially important for healthcare workers to be vaccinated to protect ourselves and those we care for.

In addition to getting vaccinated, there are other simple steps we can take to protect ourselves and our patients from the flu. These include washing our hands frequently, covering our mouths and noses when sneezing or coughing, and staying home if we are feeling sick.

If you have any questions about the flu or how to protect yourself and your patients, please visit the following link for frequently asked questions: Influenza frequently asked questions

5. Staff isolation and when to return to work

The guidance for isolation and when to return to work for colleagues who have contracted COVID-19 has been revised.

Day 1 of isolation is the day after the colleague has developed symptoms, or if asymptomatic the date the positive LFT/PCR test was taken, whichever is earlier.

Colleagues can return to work from day 6 if they have had two negative lateral flow tests, feel clinically well and have a normal temperature. The LFTs should be taken 24 hours apart. The first LFT should not be taken before the day 4 and should ideally be taken as soon as possible on waking.

Further details on the isolation guidance can be found on Connect.

Inpatient screening for COVID-19 has also been updated. Positive COVID patients should be swabbed daily using LFT from day 4. If they have two consecutive negative results and no temperature, they can be stepped down from isolation.

Patients who are positive for flu can be stepped down from isolation on day 5 if they are asymptomatic. In rare occasions they can be stepped down on day 4 but this should only be done in agreement with the ward manager/clinical lead.  

Inpatient screening for COVID-19 has also been updated and can be found on the following link: Inpatient screening guide.

6. Are you aware of norovirus and other winter illnesses?

Norovirus, also called the “winter vomiting bug”, is a stomach bug that causes vomiting and diarrhoea. It can be very unpleasant, but usually goes away in about 2 days.

The main symptoms of norovirus start suddenly within 1 to 2 days of being infected, which includes:

• Feeling sick (nausea)
• Diarrhoea
• Being sick (vomiting)

You may also have:

• A high temperature
• A headache
• Aching arms and legs

You can usually treat yourself or your child at home. The most important thing is to rest and have lots of fluids to avoid dehydration. You will usually start to feel better in 2 to 3 days. Find out how to treat diarrhoea and vomiting in children and adults.

Please stay at home until you have not been sick or had diarrhoea for at least 2 days, as this is when you’re most infectious. Do not visit hospitals or care homes during this time.

Norovirus can spread very easily, and you can catch it from:

• Close contact with someone with norovirus
• Touching surfaces or objects that have the virus on them, then touching your mouth
• Eating food that’s been prepared or handled by someone with norovirus

Practicing good hand hygiene is important – washing your hands frequently with soap and water is the best way to stop it spreading. Alcohol hand gels do not kill norovirus.

Avoid going to your GP, as norovirus can spread to others very easily. Phone your GP practice or contact NHS 111 if you’re concerned about severe symptoms or need advice

7. Are you regularly washing your hands?

Regular hand washing with soap and water remains an essential part of good hygiene and helps prevent the spread of COVID-19, as well as other winter illnesses such as colds, flu and stomach bugs.

Your hands are the main pathway of germ transmission. Hand hygiene is therefore one of the most important measures to avoid the transmission of coronavirus. It is important to wash your hands thoroughly and more often, for at least 20 seconds each time with water and soap or hand gel.

Colleagues are advised to follow the 5 moments of hand washing:

1. Before touching a patient
2. Before clean/aseptic procedures
3. After body fluid exposure/risk
4. After touching a patient
5. After touching patient surroundings.

Watch this short video to remind yourself of the how to effectively wash your hands

8. Face mask fit testing – understanding your responsibilities

As part of our preparation for winter the face mask fit testing team are reminding colleagues of their responsibilities to ensure they have well-fitting and effective masks:

• All colleagues should be face mask fit tested to at least 2 types of mask. This can include a re-usable silicone mask.
• For each type of mask that is worn, face mask fit testing should be repeated every two years.
• All re-usable silicone masks must receive an annual check, to ensure that it is still fit for purpose.
• Filters for re-usable silicone masks must be changed every three months.
• All powered air purifying respirators (PAPR) must receive an annual check to ensure that is still fit for purpose and have their filters changed every three months.

Re-usable silicone masks and powered air purifying respirators can be handed into the old security bungalow at City site for maintenance, and then collected by the end of the day.

Fit testing can be booked via ESR. Colleagues who do not have access should call 07815020836 or 07815020808.

Any queries please email scott.shenton@nhs.net or call 07866007539.

9. Return to mask wearing in all clinical areas with immediate effect

The decision has been taken to reintroduce mask wearing in all clinical areas of the Trust.

Clinical areas include:

• All inpatient wards – acute and community
• All outpatient areas
• A&E
• Theatres
• Imaging departments
• Maternity
• Home visits
• All clinical buildings including at main entrances and public areas

The decision has been taken as a result of increasing cases of COVID-19 and flu affecting colleagues.

Infection Control – Special Bulletin: 23 December 2022

1.Influenza is on the rise – Understand the risk and protect yourself, your family and your patients

Influenza is a highly contagious respiratory illness that can cause severe illness and even death, especially in vulnerable populations such as the elderly and those with underlying health conditions. As healthcare professionals, it is important to protect ourselves, our families, and our patients from the risks of influenza.

One of the best ways to prevent the spread of influenza is to get vaccinated. The flu vaccine is effective in reducing the risk of contracting and spreading the virus, and it is especially important for healthcare workers to be vaccinated to protect ourselves and those we care for.

In addition to getting vaccinated, there are other simple steps we can take to protect ourselves and our patients from the flu. These include washing our hands frequently, covering our mouths and noses when sneezing or coughing, and staying home if we are feeling sick.

If you have any questions about the flu or how to protect yourself and your patients, please visit the following link for frequently asked questions: Influenza frequently asked questions

2. Staff isolation and when to return to work

The guidance for isolation and when to return to work for colleagues who have contracted COVID-19 has been revised.

Day 1 of isolation is the day after the colleague has developed symptoms, or if asymptomatic the date the positive LFT/PCR test was taken, whichever is earlier.

Colleagues can return to work from day 6 if they have had two negative lateral flow tests, feel clinically well and have a normal temperature. The LFTs should be taken 24 hours apart. The first LFT should not be taken before the day 4 and should ideally be taken as soon as possible on waking.

Full details on the isolation guidance can be found on Connect.

Inpatient screening for COVID-19 has also been updated. Positive COVID patients should be swabbed daily using LFT from day 4. If they have two consecutive negative results and no temperature, they can be stepped down from isolation.

Patients who are positive for flu can be stepped down from isolation on day 5 if they are asymptomatic. In rare occasions they can be stepped down on day 4 but this should only be done in agreement with the ward manager/clinical lead.  

The inpatient screening guide can be found on the following link: Inpatient screening guide

3. Supporting patients with timely discharges 

We need to work together to effectively balance risk and safety by means of continually reviewing the daily discharges. This requires your support and recognising a change of practice in these extreme times. Our ask of you is to weigh up the pros and cons of our patients remaining in hospital and including patients and families in these discussions with a clear focus on what matters to them.

When planning discharges please ensure you work closely with colleagues in pharmacy to ensure the TTOs are prepared in good time.

Colleagues in the Integrated Discharge Hub are also available to support you. Call them on extension 3147 or via integrated.discharge-hub@nhs.net (open 8am – 8pm, 7 days per week).

Remember the discharge lounges are now open 7 days a week from 7am through to 7pm at Sandwell and City Hospital:

• Sandwell – Newton 1
• City – now on D28 (moved from AMU 1)

The lounges are the ideal location for patients who no longer meet the criteria to reside in our acute bedbase. Patients can be stepped down to the lounge whilst awaiting TTOs, transport or transfer to MFFD beds.

Please include the discharge lounge in your patient discharge discussions so they are aware of the journey.

4. Are you regularly washing your hands?

Regular hand washing with soap and water remains an essential part of good hygiene and helps prevent the spread of COVID-19, as well as other winter illnesses such as colds, flu and stomach bugs.

Your hands are the main pathway of germ transmission. Hand hygiene is therefore one of the most important measures to avoid the transmission of coronavirus. It is important to wash your hands thoroughly and more often, for at least 20 seconds each time with water and soap or hand gel.

Colleagues are advised to follow the 5 moments of hand washing:

1. Before touching a patient
2. Before clean/aseptic procedures
3. After body fluid exposure/risk
4. After touching a patient
5. After touching patient surroundings.

Watch this short video to remind yourself of the how to effectively wash your hands.

5. Return to mask wearing in all clinical areas with immediate effect

The decision has been taken to reintroduce mask wearing in all clinical areas of the Trust.

Clinical areas include:

• All inpatient wards – acute and community
• All outpatient areas
• A&E
• Theatres
• Imaging departments
• Maternity
• Home visits
• All clinical buildings including at main entrances and public areas

The decision has been taken as a result of increasing cases of COVID-19 and flu affecting colleagues.

6. Face mask fit testing – understanding your responsibilities

As part of our preparation for winter the face mask fit testing team are reminding colleagues of their responsibilities to ensure they have well-fitting and effective masks:

• All colleagues should be face mask fit tested to at least 2 types of mask. This can include a re-usable silicone mask.
• For each type of mask that is worn, face mask fit testing should be repeated every two years.
• All re-usable silicone masks must receive an annual check, to ensure that it is still fit for purpose.
• Filters for re-usable silicone masks must be changed every three months.
• All powered air purifying respirators (PAPR) must receive an annual check to ensure that is still fit for purpose and have their filters changed every three months.

Re-usable silicone masks and powered air purifying respirators can be handed into the old security bungalow at City site for maintenance, and then collected by the end of the day.

Fit testing can be booked via ESR. Colleagues who do not have access should call 07815020836 or 07815020808.

Any queries please email scott.shenton@nhs.net or call 07866007539.

7. Are you aware of norovirus and other winter illnesses?

Norovirus, also called the “winter vomiting bug”, is a stomach bug that causes vomiting and diarrhoea. It can be very unpleasant, but usually goes away in about 2 days.

The main symptoms of norovirus start suddenly within 1 to 2 days of being infected, which includes:

• Feeling sick (nausea)
• Diarrhoea
• Being sick (vomiting)

You may also have:

• A high temperature
• A headache
• Aching arms and legs

You can usually treat yourself or your child at home. The most important thing is to rest and have lots of fluids to avoid dehydration. You will usually start to feel better in 2 to 3 days. Find out how to treat diarrhoea and vomiting in children and adults.

Please stay at home until you have not been sick or had diarrhoea for at least 2 days, as this is when you’re most infectious. Do not visit hospitals or care homes during this time.

Norovirus can spread very easily, and you can catch it from:

• Close contact with someone with norovirus
• Touching surfaces or objects that have the virus on them, then touching your mouth
• Eating food that’s been prepared or handled by someone with norovirus

Practicing good hand hygiene is important – washing your hands frequently with soap and water is the best way to stop it spreading. Alcohol hand gels do not kill norovirus.

Avoid going to your GP, as norovirus can spread to others very easily. Phone your GP practice or contact NHS 111 if you’re concerned about severe symptoms or need advice

Chief Executive’s Message – Friday 23 December

My message this week is different as it’s a video that was filmed a couple of days ago when I reflected on how proud I am to be the chief executive of this organisation. It was heartening to see how everyone came together to manage and help get us through unprecedented pressure on our services this week which saw our organisation declare a critical incident.

Everyone involved really demonstrated our values:

• Ambition – to find innovative means to support each other and our patients
• Respect – for each other as colleagues working towards the same goal of delivering good care, with community teams and hospital teams working in tandem to decongest our EDs
• Compassion – for our patients who very often just want to be treated quickly so they can get back to their loved ones

As the year draws to end let’s remind ourselves of the excellence that can be achieved when we truly support each other.

If you are working during the festive period – thank you. Don’t forget to take advantage of offers such as a free meal from our restaurants on Christmas Day. Also please do cash in your £10 voucher through the SWBH benefits scheme, which is a small token of our appreciation for everything you do.

Thank you for the kindness you have demonstrated to our patients, relatives and each other.

Merry Christmas and a Happy New Year.

Festive photos from across our sites – Merry Christmas!

In the build up to Christmas, colleagues have been spreading festive cheer throughout the Trust.

Colleagues and volunteers sang Christmas carols for our patients, colleagues got into the Christmas spirit by wrapping up presents ready for our patients and West Bromwich Albion football players visited our children’s ward earlier this week plus much more!

Thank you all for spreading festive cheer. Merry Christmas and a Happy New Year!

New checklist for resuscitation equipment

A new and updated emergency equipment checks are coming in 2023, however in the interim, colleagues are requested to ensure they print and use the monthly checklist attached below.

This checklist should be kept with the 2022 emergency equipment booklet on the resuscitation trolleys.

Emergency Equipment Checklist.