Message from David Carruthers, Medical Director and Acting CEO: COVID-19 Summary

October 23, 2020

Dear Colleagues,

The increase in community Covid cases is now having an increase effect on admissions to our hospitals. Over the last few days we have seen a jump in Covid admissions without any reduction in presentation of non Covid patients. You and your teams have all worked hard to return service for your patients towards a normal level and we were seeing improvement in our waiting times for out patients and reduction in waits for surgery and investigations. Work goes on in the independent sector and collaboration with partners in  the Black Country continues to look for ways of improving the services we provide. Admission avoidance, early discharge and community support and monitoring are all important aspects of our care. ICU capacity has been well managed with support from partners but beds remain a challenge across the system.

We continue with our 4 streams of patients to try and reduce risk of nosocomial infection but are seeing an increase in number of patients with a symptomatic infection on amber wards, highlighting the need to continue with strict infection control processes at all times. Relative low numbers of side rooms means that for now we think maintaining the lilac stream to cohort contact patients is important. Swabbing also remains an important part of risk reduction of Covid transmission and the labs are working hard to support us either with quick turn around swabs for red admissions or via Black Country pathology for 24 hour tests. POCT is not yet available.

So, while we try and maintain provision of services that have been restored, cope with normal levels of non Covid admissions, have 4 streams of patients and have this step up in Covid admissions we are moving through the trigger points of the surge plan. This needs an increase in red bed capacity and until now we have aimed to manage Covid patients within our respiratory hub at City for the expertise that can be provided with management of more severe lung disease. We are now at a point where beds are needed at Sandwell to reduce the number of red admissions at City as well as minimising inter hospital transfers. In the absence of empty wards this time it will take a few days to settle the ward moves while inconveniencing patients and teams as little as possible.

We are grateful for the work and support you are providing at this time of uncertainty and change. We hope that we can minimise disruption of the services you and your teams have worked hard to restore and will work to minimise the risk of staff redeployment. We continue to watch what is happening within the community, to work with partner organisations and hope to minimise the risk of last minute changes in ward allocations or service provision at SWBHT.

Please continue to support colleagues who may be anxious about any potential changes and keep working together to manage this increase in cases which I hope will plateau soon. Making sure we don’t add to the problem with hospital acquired cases or staff needing to isolate after case contact are even more important now. Please keep an eye out for the twice weekly Covid bulletin for general updates and I’ll keep in touch with anything else of importance.

I remain grateful for the support and professionalism you all continue to show for the benefit of our patients.

Best wishes

David Carruthers MBBS PhD FRCP
Medical Director and Acting CEO