Heartbeat: COVID-19 in the community

September 28, 2020

Whilst the response to COVID-19 in our acute hospitals has been amazing, it’s time we recognised the incredible work that has been happening out in the community, with testing teams responding to outbreaks and community nursing teams tending to at risk patients – all whilst a nation went into lockdown.

It’s often easy when you think about healthcare and the response to COVID-19 to focus on hospitals and patients arriving at emergency departments, yet at our Trust, almost 70 per cent of our care is delivered to patients out in the community, to patients who are frail, elderly, infirm or generally unwell; patients who regardless of lockdown and this pandemic still need to receive care.

Throughout the pandemic, clad head to toe in PPE, colleagues in the community have continued to deliver care to patients in the community and have also played a pivotal role in the management of outbreaks in the community.

To find out more about the work of the community teams, Heartbeat spoke to Tammy Davies, Group Director of Primary Care, Community and Therapies. She said, “Our community teams have done an outstanding job at a time when our community was in need. They have demonstrated all that defines our Trust in their determination, compassion and care.

“When COVID-19 began to have an impact locally, our teams were able to very quickly change the way they work whilst still providing the same level of care. Whereas in the past we would have district nursing colleagues working on their own and driving from visit to visit, we were able to partner up and offer vans so that colleagues had somewhere safe and secure they could don and doff their PPE before visiting patients, and most importantly, this meant that we continued to see COVID-19 positive patients.

“We knew early on that COVID-19 would inevitably mean that we would have many more patients moving into our palliative care and end of life services so we needed to act quickly to restructure our services to ensure we were able to provide the best level of care. One of the biggest changes was the conversion of Leasowes Intermediate Care Centre into an end of life care facility where our patients could be moved to receive high quality, patient-focused end of life care in their final days.

“Our teams also began working much more closely with local care homes, providing advice and training on how to use PPE safely as well as much needed fit testing. With all of the focus nationally on hospitals and the NHS, it would have been very easy to forget that we have huge numbers of vulnerable people living in care homes and that they fit the profile for COVID-19, where the virus has a particularly high mortality rate in older patients who have pre-existing comorbidities.

“By offering early intervention in the community, through awareness raising and proactive engagement we were able to begin to make progress in tackling the virus. Our teams have worked closely not only with our staff in providing swab testing and antibody testing but also the local authority too. We opened a range of testing sites at Sandwell and City and supported key workers to be tested. To date, these testing facilities have swabbed over 5879 people to test for current COVID infections as well as completing over 12,295 antibody tests.

“As the government mandated lockdowns have eased and the local economy has begun to return to normality, our outbreak teams have been once again out supporting the local authority and partners in public health to identify, test and manage local outbreak clusters. This has meant that our region has been able to react quickly, identify at risk patients and to proactively support them and prevent further transmission.

“Through close working with colleagues in primary care, we have been able to stay ahead of the virus in the community, our GP colleagues in Your Health Partnership (YHP) joined our Trust in April, in the height of the pandemic, however, they very quickly set up a COVID red site where a patient who had tested positive could go to for care, limiting the risk and impact at their other clinics.

“The reach of our work hasn’t just been in the community either, our colleagues were also involved in the large scale redeployment in our Trust to bolster our inpatient and acute services, and we had colleagues move to medicine and into ITU offering a seven-day rota for therapy services.”