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Critical incident stood down: Now at escalation level 4

January 6, 2023

This afternoon we have taken the decision to stand down our internal critical incident status, however we remain at operational escalation level 4.

Whilst this is a positive development, our hospital sites remain under significant pressure, and it is imperative that we continue to take all necessary actions to ensure the safety and wellbeing of our patients.

Our command and control structures remain in place. 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 into the community.

Supporting patients with timely discharges

Please continue to consider why every single patient needs to be in hospital and what we can do to safely support them to get home or to a community facility.

As soon as someone no longer requires hospital-based intervention it is usually a greater risk to keep them in hospital than to discharge them.

Our community services offer a range of health and care interventions to support discharge, for example:

  • IV antibiotics
  • Oxygen weaning
  • Nebuliser care
  • Remote monitoring
  • Blood tests and associated medication changes

If people need care packages at home, temporary or permanent placements to a care home or end of life care, there are a number of options in the community.

The Integrated Discharge Hub on ext 3147 will offer advice and support for all patients with No Criteria To Reside (NCTR – previously known as “medically fit”).

If a patient is not yet medically optimised we may be able to continue their medical treatment and monitoring in the community. Please consider our consultant led, community delivered virtual wards. If you have any patients who may be suitable, please contact 2664 (option 4) to discuss.

During every board round and safety huddle please ask the following questions for the MDT to consider:

  1. Why is this person in hospital? Why not home and why not today?
  2. What treatment is this person receiving? Could this be continued at home?
  3. What investigations are they waiting for? Why can’t they be done as an outpatient?
  4. Why are we re-checking blood tests? Will this change our care or treatment? Why can’t this be done in the community?
  5. Is this person waiting to see a therapist or specialist team? Why can’t this be done in the community?

If this person is medically optimised (NCTR) why are they still in an acute bed? – call the Integrated Discharge Hub for support and advice on ext 3147

 

COVID-19 / Flu Isolation and Swabbing Reminder

Please ensure we are swabbing patients correctly so that we can prevent outbreaks and reduce the risks of further transmission.

On Admission

Patients should only be swabbed for COVID-19 and flu if they are symptomatic or are clinically vulnerable.

Clinically vulnerable patients are those with any of the following conditions:

  • Down’s syndrome
  • Certain types of cancer (such as a blood cancer like leukaemia or lymphoma)
  • Sickle cell disease
  • Chronic kidney disease (CKD) stage 4 or 5
  • Severe liver disease
  • Cerebral palsy
  • Had an organ or bone marrow transplant
  • Autoimmune or inflammatory conditions (such as rheumatoid arthritis or inflammatory bowel disease)
  • HIV or AIDS and have a weakened immune system
  • A condition affecting the immune system
  • Conditions affecting the brain or nerves (multiple sclerosis, motor neurone disease, Huntington’s disease or myasthenia gravis)
  • Severe or multiple learning disabilities
  • A weakened immune system due to a medical treatment (such as steroid medicine, biological therapy, chemotherapy or radiotherapy)

During admission

Please swab any patient who develops clinical symptoms of flu and COVID-19 immediately using a PCR test.

Discharges

Any patients being discharged to care homes must have a COVID-19 PCR test carried out no more than 48 hours before discharge.

Any patients being transferred to Rowley Regis Hospital must have a Lateral Flow Test (LFT) completed prior to transfer.

COVID-19 step down of positive patients

Positive patients should be swabbed daily using Lateral Flow Test (LFT) from day 4 (Day 0 is the date the first +VE swab was taken)

Following two consecutive negative results, 24hrs apart and no temperature a patient can be stepped down from isolation.

When completing a LFT please ensure that the correct Powerform is completed within Unity.

Flu step down of positive patients

During normal working (EMS Level 1/2) Isolation can be stepped down at day 7 if the patient is asymptomatic.

When the Trust is under severe pressure (EMS Level 3 and above) patients can be stepped down from isolation on day 5.

For more information, please call ext. 5900 or email swb-tr.SWBH-Team-InfectionControl@nhs.net

 

Mask wearing is now mandatory in all clinical areas

Mask wearing is required in all clinical areas of the Trust for staff, patients and visitors.

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

 

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.