COVID-19 Bulletin: Monday 27 April

April 27, 2020

This is our every single day bulletin. Please use this bulletin and cascade arrangements within care and corporate groups to guide your actions. Remember KINDNESS is our watchword in implementing our plans. In the rest of April and throughout May we are determined to reduce avoidable harm and death in the people we are taking care of.

We went live today with our Power-form in Unity for Proning. It is really important that we record the work being done, not just in Critical Care, but in our Assessment Units and Wards to deliver this intervention, which our clinical leadership considers potentially significant for outcomes. Both undertaking proning and the data input will take up your time and we have considered carefully the benefit to patients. Please enact this change immediately.

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

1. Asymptomatic staff testing pilot – community focus

Over the next two days the Trust will be taking part in a national pilot to test asymptomatic staff, key workers and some patients.  If you work in one of our primary care, adult or paediatric teams in the community, you will be able to access testing at Little Lane.  We are also contacting staff affected by the failed tests we undertook in mid-March.  The booking arrangements are as below:

• Call 0121 507 2664 option 5 to book an appointment

Appointments might take slightly longer than in other situations because there is some data to be collected to undertake the study component.  The tests have to be undertaken by the end of Wednesday.

2. Lilac is still coming and so is asymptomatic patient testing – from tomorrow!

As mentioned in both Friday and Sunday’s bulletins, we are seeing falling volumes of query COVID-19 red admissions.  At the same time testing capacity and turnaround times are different now to what we had available in March and early April.  With this in mind we are making three key changes:

1. All inpatients admitted to the Trust’s care will be swabbed.  The test will typically take 24 hours to turnaround and so clinical judgement will still be the basis for Red stream or Blue stream admission.
2. Patients who test negative in the red stream will often then be transferred to a designated Lilac Ward.  This recognises that being in the red stream could increase the risk of a future test positive.  But the ward will be managed in line with our blue protocol for diagnostics, transport and PPE.  A clinical protocol will be issued to describe circumstances where clinical judgment will retain a patient in the red stream despite a negative test, because of high suspicion that the patient concerned has a false negative result.
3. With immediate effect blue stream patients who become symptomatic will not be transferred to a red ward, but will access the rapid turnaround assay test, and their ward for ongoing care will reflect that result.

The table sets out the approach that has been developed by the clinical leadership community. Click here to enlarge the table.

Lilac wards will open by Wednesday afternoon, and their location will be confirmed tomorrow.  There will be one at Rowley Regis (Westwood) and one at each of City and Sandwell.

3. Keeping talking at this confusing time

The national narrative about COVID-19 is in some flux.  Lockdown continues but may be eased in May.  Volumes of non-COVID 19 care provided in general practice and hospitals is falling.  There is a clear flattening of the curve of Covid-19 admissions.  But there is an unknown factor associated with easing home restrictions and anxiety that it will lead to less social distancing and recklessness around hand hygiene.

At the Trust too our plans are in transition.  Serenity is relocating back into its original location.  Cancer care remains off site.  We would expect by early May to re-start some elective surgery but to retain outpatients on a virtual basis.  Redeployment and brigading remains extant and is unlikely to change before the end of May.

That flux gives rise to questions and so Wednesday’s latest Chief Executive WebEx sessions are well timed.  The details of how to join are below…

Wednesday 29 April

12pm-1pm:

To join the session from your computer click on the following link: https://swbhnhsevents.webex.com/swbhnhsevents/onstage/g.php?MTID=e737794bbd8960311971d6c21547c1934

Event password is SWBCOVID

5pm-6pm:

To join the session from your computer click on the following link: https://swbhnhsevents.webex.com/swbhnhsevents/onstage/g.php?MTID=ea90ea4820b98b54bb0da756b6b0b8741

Event password is SWBCOVID

4. Sign up to plasma donations:  Science wins…

As part of the national research effort against coronavirus, the NHS Blood and Transplant Service are leading a programme to collect plasma donations from people who have recovered from COVID-19. Donations of plasma will be used as part of a treatment trial to establish whether COVID-19 convalescent plasma, that contains antibodies against the virus, benefits patients and at what point in their illness they should be treated.

We are contacting our many COVID-19 positive safely discharged patients.  But we have many staff who have also tested positive, recovered and returned to work.  We need your help!

If you have had a positive test for COVID-19 or have had symptoms you can help by registering to donate plasma at the Birmingham centre. Read more about the trial and how to donate here.

5. Honouring those key workers who have died

Across the country tomorrow there is to be a minute’s silence.  This is to acknowledge, remember and pay tribute to key workers who have lost their lives due to coronavirus.  The Trust, with fortune, has not yet lost a colleague, but all of us may know someone in public services who has passed away.  Across the NHS there is clearly a striking loss of colleagues from Black and Minority Ethnic backgrounds, as yet unexplained.

Tuesday 28^th is International Worker’s Day, and that is why tomorrow has been chosen.  The silence will take place from 11.00 am and if you wish to take part that is entirely to be encouraged.  Take a moment silently and consider those lost so far.

You will be aware of publicity associated with local community concerns over the care of members of the Black and Minority Ethnic community.  Our Deputy Medical Director, Sarb Clare, has been discussing these concerns and her reflections are in this short film.