COVID-19 Bulletin: Thursday 14 January

January 14, 2021

Numbers not statistics: This week (last week)

1. New: Safe patient care: Focus on discharge arrangements

As you know, hospitals all around the country are facing unprecedented strain. Where possible we must do what we can to manage the number of patients staying with us and discharge patients wherever clinically safe.

Acting Chief Executive, David Carruthers has written to all consultant colleagues expressing the need to support early discharge, how to do it, and the protection in place if colleagues are working in areas that are not their usual areas of practice.

We have also published on Connect a pathway which sets out the discharge process from an acute setting.

There are a number of services available to you supporting patients at home that will enable early discharge:

COVID-19 Virtual Ward – Monitoring You at Home (MYAH)
The Monitoring You at Home (MYAH) Service is a COVID-19 virtual ward operated by iCares which accepts referrals for patients from SWB wards and ED. The patients must:

• Have been diagnosed with COVID-19: either clinically or via a positive test result AND are symptomatic
• Be aged 18+ years.

Referrals will be accepted via the form on Connect.

The last referral will be accepted at 6pm for patients to be seen same day. The service operates 7 days/week. Patients will then be provided with a pulse oximeter, symptom diary and safety netting advice. The MYAH Service will regularly contact patients to support them in the community. Patients will be monitored for 14 days from the onset of symptoms, after which they will be transitioned to either a rehabilitation phase, alternative community services, discharged or remain on monitoring.

Discharge to assess hub (D2A)
The D2A team conduct daily reviews of patients requiring discharges and also put plans in place for those patients who could potentially be discharged.

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.

You can contact the team on 07815 647936, from 8am to 5pm, 7 days per week.

Support for patients in the community
There are a wide range of services available to patients once discharged home including district nursing and rehabilitation. See the latest information regarding the support available.

2. New: Refreshment provision for colleagues

We recognise the pressure that all colleagues are facing whilst at work and want to make sure that people have easy access to food and drink.

Out of hours staff fridges and freezers are located on D18 City and Main Reception at Sandwell. The fridges are being stocked with a selection of sandwiches and wraps including vegetarian and vegan choices along with crisps and that’s every afternoon from as of now. The Sandwell fridge will be unlocked by security at around 9pm ready for the night staff.

The CCU ward and A&E will also receive a direct daily delivery of sandwiches for staff who are unable to leave the area.

A selection of frozen meals were delivered earlier today to the Trust and the freezers stocked. These will be checked and topped up daily as required.

Staff vouchers are being distributed to all wards across City and Sandwell.

Bottles of water and cartons of fruit juice are being delivered daily to all wards across both acute hospital sites along with a number of departments as requested and snacks continue to be delivered weekly to every ward across Sandwell and City as well. An additional weekly snack delivery has been arranged to Critical Care to help.

Rowley and Leasowes are not being forgotten in all of this and they will also be receiving fridges and freezers for sandwiches and frozen meals for their out of hours workers. They will also receive the same drinks and snack on offer as Sandwell and City – as well as the aforementioned vouchers.

If areas require anything specific, need to report notify any issues or have any general queries please speak to your team leads so that it can be brought forward.

3. Update: Purple bags = rapid swabs

 As you know from our Tuesday bulletin, purple bags are back in circulation.  If speed is of the essence with your sample, then purple bags make identification and prioritisation easier for the lab. These are replacing the “being phased out” urgent two hours priority stickers, which can still be used as necessary.

The update comes in the form of our further information guidance, which has had some additions following feedback to include an additional step. You can familiar yourself with this processing sample guidance on Connect.

Remember: Wards must regularly check to ensure that they have adequate stock of COVID-19 swabs and purple bags for the weekends and out of hours.

Please note that rapid swabs are not processed overnight but will be done the following working day.

 If you have an urgent sample:

• Place the correctly labelled specimen into a clear specimen bag and sealed fully
• Repeat this process, using the second larger clear zip locked specimen bag
• Add this doubled bagged specimen to a purple urgent COVID sample bag
• The purple urgent bag can now also be posted into the COVID drop off box.

Additionally, there has been a change in the number of rapid allocations: