COVID-19 Bulletin: Friday 12 November

November 12, 2021

Numbers not statistics: This week (last week)

1. New: National policy announcement on frontline mandatory vaccination for health care staff

Colleagues may have read or heard about a new government policy which will affect all frontline colleagues regarding compulsory COVID-19 vaccination. Whilst we are yet to receive the detailed national guidance on what this means for our staff, it is nevertheless a clear signal that vaccination is expected for all NHS staff, particularly those providing direct patient care. Please see attached letter for more information.

Thank you to the vast majority of our staff who are up to date with their COVID vaccinations and boosters, we appreciate your diligence. We will provide more detailed guidance on our Trust approach once we have received and reviewed the national guidance, but in the meantime we continue to urge you to book your COVID vaccines/booster jab or walk in to the following hubs:

• The City vaccination hub will remain open seven days a week where colleagues will be able to receive their flu jab and COVID booster.
• A pop up clinic at Sandwell will be held on 24 November in the Berridge Room in the Sandwell Education Centre.
• A pop-up clinic is also operating at Rowley Regis Hospital, where no appointment is needed. The next pop up at Rowley is due 25 November, with walk ins able to come in to Westwood ward from 9am – 4pm. Colleagues will also be able to get their vaccinations at Tipton from now and throughout December.

There must be at least six months (182 days) between your second dose of your COVID-19 jab and your booster. Any queries please call the vaccine hub on 0121 507 4404.

If you are concerned and need support and information about vaccination please contact Occupational Health on 0121 507 330

2. New: COVID-19 Self isolation exemption protocol

We have amended the staff self-isolation protocol as a means to ensuring patients who are in urgent and life threatening situations have the best opportunity to get the treatment they need. The amended protocol is attached, but in summary this means that in the event a colleague has been identified as a contact of a positive COVID-19 and the individual lives directly (same household) with a positive COVID-19 case, they will be asked to not come to work unless there is a clinical need that may result in sight loss, cancellation of urgent cancer operations and life/death situations. An urgent risk assessment process should be completed and a return to work should be considered in circumstances where there is a risk to health or safety, or the safety of providing continuing clinical or care services resulting from staff absence and alternative options have been explored and there is no alternative available. Fully vaccinated (14 days post vaccination) frontline NHS and care staff in this case, if identified as a close contact in your household of a positive case, could be asked to leave self-isolation in order to attend (including travelling to and from) work.

The decision to allow staff to attend work should be made on a case by case basis, after a COVID-19 Self-isolation Exemption Decision Assessment has been completed by an individual(s) line manager, and then only after authorisation by the Director of IPC or Deputy Director IPC (on call manger out of hours). In order to mitigate the increased risk associated with this exemption, the risk mitigation process flow chart must be followed.

3. New: Easing of visiting restrictions from 17 November

From 17 November 2021 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 current not allowed should ensure you have robust systems in place to community 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 and numbers of COVID-19 cases in our hospitals.

4. New: Point of Care Testing LIAT – Are you an authorised user?

Colleagues are reminded that only trained users within agreed departments are to use the POCT LIAT rapid testing systems. Only departments such as ED, Paediatrics, Surgery (pre-assessment) and Endoscopy are currently approved.

Colleagues should not loan or borrow access barcodes with others.

Misuse of these critical machines is leading to breakdowns and failures that ultimately impact on patient care. Please remain vigilant and refer to the microbiology team if you have any queries.

5. Reminder: Spit in a tube rather than a stick up your nose

LAMP – it’s a completely pain free testing system that just needs you to remember to take a saliva sample by spitting in to a tube first thing in the morning.

LAMP testing is pain free and remains one of the least invasive tests we have for COVID-19 whilst also being incredibly accurate. You just need to remember to take your sample before you brush your teeth or have your breakfast. Alternatively, if you forget, you just need to leave an hour before taking a sample.

Collection slots for testing kits can be arranged by calling 0121 507 2664 and selecting option 6 to register and book a kit collection slot  Mon – Fri 8am – 6pm

When you have taken your sample and 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.

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:

6. Reminder: Celebrating safely and behaving responsibly

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. And whilst colleagues will be keen to arrange get togethers, please keep this in mind.

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, their skills as clinicians and avoid risky environments. Continue to wear masks when your 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: Taking time out with your teams

Taking time out is important for mental and physical wellbeing, particularly after a difficult period with the pandemic.

Many teams have already taken advantage of the opportunity to have team time outs – stepping away from the work environment to reflect on experiences.

For those of you who haven’t had a chance to, you have until the end of March 2022 to take advantage of this great opportunity.

Time out can take a range of formats, but in order to help managers, the Trust is happy to consider centrally funding reasonable costs associated with these time-outs.

This could include:

• Hire of an external venue
• Facilitator/external speaker costs
• Transport to external venue
• Refreshment costs (no alcohol)
• External team building activities
• Backfill costs

Get your thinking caps on and have a think about things you and your team might enjoy while taking some well-deserved time out.

How was your time out?

We want to hear your stories and see your photos so we can share and inspire other colleagues. Email your stories to swbh.comms@nhs.net.

Visit Connect for more information on team time outs including criteria and how to apply.

Please ensure you have agreement from your group director before submitting requests.

8. Reminder: Comin’ home for Christmas (with the help of D2A)

No one wants to spend Christmas in the hospital, we want as many of our patients as possible to be supported to go home, spend time with their family and to take their time to recover in their own surrounding. Might sound like wishful thinking but it’s a task that the Discharge to Assess (D2A) team  would happily take on to make sure we have our social care partners ready and waiting to take over supporting our patients at discharge.

D2A is a ‘home first’ model and is a postcode blind system, so the same processes apply from a ward perspective for a Sandwell patient as they would for a Birmingham patient.  And critically, it doesn’t focus on the provisions available and instead looks to identify the actual needs of the patient.

D2A also introduces a new language around Medically Fit for Discharge,  which now becomes known as ‘Criteria To Reside’. This is not simply a change in language but about changing a mindset and really challenging each other and clinical teams to justify the criteria keeping the person in hospital.

For patients who require ongoing support from health or social care services after they have completed their acute medical treatment, D2A allows them to be discharged within 24 hours and their needs assessed in the community – usually their own home. This means they have more meaningful assessments e.g. climbing their own stairs, or making themselves a cup of tea in their own kitchen – things we can’t replicate in the hospital environment.

The team will help with patients on the following pathways:

• Pathway 1 = Support to recover at home; able to return home with support from health and/or social care.
• Pathway 2 =  Rehabilitation or short-term care in a 24-hour bed-based setting.
• Pathway 3 = Require ongoing 24-hour nursing care, often in a bedded setting.
• Pathway 4 = End of Life pathway.

All wards are encouraged to use the D2A service for support or queries relating to discharge. Usual processes are unchanged but responses are swifter so please ensure your patients are prepared for discharge as soon as they are declared medically optimised.

The Integrated Discharge Hub team are on hand, from 8am to 8pm, 7 days per week and can be contacted on 07815 647936.