Chief Executive’s Message – Friday 29 May

May 29, 2020

Antibody testing for COVID-19 launches on Monday at the Trust. In truth our understanding of the science of the disease means we have incomplete knowledge of how and for how long such antibodies might protect an individual. Notwithstanding, unless you currently have symptoms or have had in the last 3 weeks, we are suggesting you do get tested. However, it is really important that regardless of your test result you continue to:

Wash your hands obsessively
Maintain social distance at work and at home
Wear, and correctly take on and off, the right Personal Protective Equipment

This week I have had occasion to insert into our bulletin a reminder about covering uniforms when travelling, or buying groceries, and about not wearing scrubs off site. I guess in the same vein of restatement, it is worth noting that gloves and aprons must be changed between patients. All of these nudges are about how we work together to maintain vigilance over the summer while we continue to manage the virus.

Today in our Board’s quality and safety committee we looked at ‘cross infection rates’ of patients who may have been admitted without COVID-19 and then developed it, perhaps from another patient, or more likely from one of us. Rates of cross infection appear lower in the Trust than elsewhere, but may be rising. That suggests that, even as the national position appears to be being relaxed, we need to take great care of ourselves and those entrusting themselves to us. That is why we are maintaining extra cleaning in clinical environments, and why Wednesday’s Working From Home guidance maintains and indeed expands such arrangements between now and the end of July. All of us have a part to play in making sure our behaviours help to curtail COVID-19 spread.

Next Thursday we launch our revised employee risk assessment protocol which aims to understand the various risk factors that someone might have which could make them more susceptible to the virus. Masood Aga and the occupational health team have worked to develop this, alongside senior clinicians. The bulletin will explain how to access an assessment, and, as I wrote last week in terms of my discussions with BAME colleagues, this assessment will then drive a high, medium or low risk rating. On a person by person basis we will then act on the results, with the most likely outcome of a medium rating being revised PPE for an individual.

It is foreseeable that as COVID-19 becomes more personalised, with some having antibodies, and changed equipment that is individually allocated not just locational, there is a risk of stigma arising. Sadly, this could be societally linked to higher risk groups – and prejudices could come to the fore, or indeed unconscious bias. We need to work together to recognise that any of us could have or spread COVID-19, and whilst we have to make it ok to discuss individual risk factors, we need to make sure that no-one feels they are being avoided or shunned or treated differently because of the disease. As I began this message with, all of us have a 2m exclusion zone around us, even if now we can see some of friends and family in next door’s garden in the sunshine.

This week’s Star of the Week is Joanne Tonks, Osteoporosis Nurse, who was nominated by several colleagues for the way she has co-ordinated the Trust’s COVID-19 community swabbing teams. Jo has been praised for her support to all staff who have been deployed into the swabbing response, ensuring that they are suitably trained and kept up to date with the latest guidance. She is always available for help and has made sure that we continue to provide an excellent swabbing service for staff who have symptoms, their family members and care home staff. Thank you, Jo.

During June we will see most colleagues moving back to prior roles. I very much hope that where new skills have been learnt there is a chance to keep those skills and with that in mind we are looking at hybrid roles and second role specifications. As we move towards winter, let alone a second surge, we need to consider how best to retain acute and assessment skills developed during the pandemic. At the same time, we need to recognise that some roles are changed forever by the pandemic. Outpatient nursing is, for instance, a specialist skill. But the advent of video-based consultations will change the job in very many ways. As we move through June we will look to make sure we develop support programmes for roles where that transformation is evident – for example anyone who line manages someone may need help with simulating how to do so if that employee works from home. It’s a subtle message – not everything is changed by COVID-19 but everything is touched by it. Some of the energy from the pandemic across the Trust has come from making experimental change at speed without waiting for extrinsic instruction and we want to try and maintain that sense of getting on with things that will improve care.

Last week we handed out our second ever QIHD Gold Award, this time to Trauma and Orthopaedics. I write about that in this month’s edition of Heartbeat (available on line and in wipe-able print). The team’s story continues but started with a safety summit about avoidable harm and possibly deaths. The review of COVID-19 deaths as a Trust for March and April will feature in June’s QIHD learning pack, with six cases where practice could have been improved (even if death was probably not avoidable). The honesty of using this data transparently and committing to make change, and the dedication to talk as a team in QIHD time and make that happen, is the golden thread we have been trying to create at the Trust over many months and years. Let’s recognise such successes in our Star Award nominations in June, and document our learning in the QIHD Posters we develop for December’s contest.

#hellomynameisToby