Heartbeat March 2020

It’s not all about hospitals: Read about
our community response to COVID-19
Mel Roberts
Group Director of
Operations - Primary
Care, Community
and Therapies
Most of the services in the community
have had to think quickly about how they
previously delivered care and what they
need to do now. This has meant that
some of the developments have needed to
happen at pace. Community teams have
been amazing in how quickly they have
responded to these changes and developed
their own ideas about how to provide care
safely for our vulnerable patients. Services
that were deemed more ‘routine’ or nonessential
have either been scaled back or
are being offered virtually via technology.
Helen Hurst
Director of
Midwifery
Babies will not stop arriving and unlike
many other services, we cannot reschedule
for a later date! Our service comes with a
time specific package, an incubation period
all of its own - 40 weeks approximately. So,
how can we do things differently?
Well, we have a developed a business
continuity plan based on guidance from
the Royal College of Obstetricians and
Gynaecology that covers the impact on our
available workforce. Our consultants in both
obstetrics and neonates are undertaking
clinics remotely where possible and we have
aligned the pathways to reduce the need
for multiple appointments. Our sonography
team and obstetricians have developed a
plan for screening of unborn babies, with
reduced attendances. Our community
Face to face activity has been reduced to
minimise the infection control risk.
Admission avoidance visits across the
community continues to be a priority as
does support to discharge patients from
ward areas to ensure patient flow.
There is no doubt that these are difficult
times. Everyone is affected personally
in a different way. There are anxieties,
mostly around PPE and safety. Front line
colleagues are worried because community
work in patients’ own homes can be quite
unknown until you get there. But there
are also worries about family situations
– elderly relatives, childcare and loved
ones. Colleagues are coping remarkably
well during what is a very uncertain time.
There is a real sense that we are all in this
together and a willingness to be flexible to
do what needs to get us all through.
teams are working from their bases on
the whole, undertaking post-natal triaging
and ensuring our most vulnerable families
continue to have care in their homes, whilst
we deliver other care via postnatal clinics.
Inpatient (maternity and neonates) services
have created hot zones and pathways
to care for our women and babies with
confirmed or suspected COVID-19. These
areas are also used by our community staff,
ensuring we are working together as one
family.
We are all anxious, worried and scared.
But we are coming together united in
one belief that we will persevere. We will
ensure all our staff, women and families are
supported during this unprecedented time
and things that we put in place now will
help to shape our service to come.
As midwives our worry is that women will
choose not to engage with us as they are
scared and we see an increase in mortality
and morbidity that we have worked so hard
to reduce. Now, more than ever, we need to
listen and advise.
COVID-19
Dottie Tipton
Primary Care
Liaison Manager
There have been several changes to GP
practices and how they work. We now
have two ‘hot’ sites set up to manage
symptomatic patients from practices across
Sandwell and West Birmingham - Parsonage
Street that previously housed the Walk in
Centre and our own Lyndon Health Centre,
and Aston Pride Health, which was a branch
practice of Newtown Health Centre. All
patients will be booked into appointments
at these sites by their own GP Practice
or by colleagues in NHS 111. Walk-in
appointments are not available.
Practices across Ladywood, Perry Barr and
Sandwell have swiftly moved all services
to a telephone triage model, much like
our hospital outpatient clinics. For a few
patients that will mean they will be invited
into practice to be seen, if the consultation
by phone or video is not enough.
A home visiting service went live on 30
March with an initial capacity of 10 slots
per day and plans to expand. The service
will take referrals from practices for patients
who need a home visit but do not require
district nurse input. Some practices have
seen as much as 25 per cent reduction in
available workforce and therefore practices
are looking to reduce the number of sites
that patients are seen face to face.
It’s not all plain sailing, though and practices
are worried about a number of things
including whether they can have access
to staff testing which we are looking to
support.
Cheryl Newton
Group Director of
Nursing - Women
and Child Health
Children and families in our communities
still require support, even more so with the
requirements of self-isolation and social
distancing. The formal and informal support
networks for families with newborn,
toddlers or school age children are now
significantly reduced which can mean
people need more support from us, not less.
We are using various technology to give
them access to our community children’s
nursing team when they need us.
We recognise that some of our families with
increased vulnerabilities may still need face
to face contact and this is being maintained
where possible. We have developed
business continuity plans across all of the
children’s community services. Our staff
groups are adopting a flexible approach to
providing on-going support to our children
and families. We are utilising technology
to provide virtual appointments where
appropriate and offering face to face
contacts for those children who
require it.
The impact of self- isolation and social
distancing on the emotional health and
well-being of our communities remains
to be seen. Our main aim is to help
families continue to reach out to our
services for support during this time and
we want to ensure that the child’s voice
is still heard as families deal with the
extraordinary circumstances we all find
ourselves.
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