This is a slightly longer newsletter than usual because I am keen to keep you informed about the next significant stage in our response to Covid-19 which is our intention to resume planned surgery. This, and indeed all aspects of the pandemic, has been occupying my thoughts during the last week, as well as events in America. The death of George Floyd and its aftermath prompted me to send a message of solidarity to our black colleagues.
As I hope has been clear through this weekly newsletter, I am determined to share with you our plans and how our response is changing as we adjust to living with the virus for many months to come. Our website is where we post all relevant information including, for example, the news of the creation of our Same Day Emergency Care unit at Queen’s Hospital and the change to the location of our antenatal services at King George Hospital.
Re-introduction of planned care
During the peak period of Covid-19 we had to postpone routine planned surgeries for patients, in line with national guidance. From this week, we intend to begin a phased re-introduction at King George Hospital (KGH).
We are leading the North East London (NEL) Elective Care recovery plan and we are working through our planned surgical lists for our more urgent patients across the Integrated Care System (ICS). We are working with, among others, Barts Health and the Homerton. All of our work will be driven by the need to minimise risk and provide safe care and will be in line with NHS and infection prevention and control (IPC) guidance.
We are going to begin slowly reintroducing planned surgeries from Wednesday 10 June.
Current guidance is for planned and all other work (including urgent and emergency care) to be separated as much as possible. This means reducing the movement of staff by keeping them in the same areas and avoiding the crossover of these pathways.
As a result, from tomorrow (9 June) KGH will be split into different coloured zones, which have their own entrances and exits in order to protect staff and patients and to prevent cross contamination. A map showing this will be on our website from tomorrow. Colours refer to the following:
· Green is for Covid-19 protected (CP) –planned care pathways
· Yellow and Blue is for Covid-19 risk managed (CRM) – all other hospital areas including urgent and emergency care.
This reconfiguration will help to ensure patients who need planned care can be checked to see if they have Covid-19 before attending our hospitals for their procedures. Once they have been admitted they can be protected, as best we can, from the risk of cross infection from staff or patients who may have the virus.
Clinicians have been reviewing our waiting lists of patients and prioritising them in line with guidance from the Royal College of Surgeons and the NHS.
We are contacting patients who are due surgeries imminently and we have explained our new processes to them, including the need for them to:
· use the new dedicated KGH entrance (they cannot use the main entrance)
· self-isolate for a specified period of time (dependent on the procedure they are having) before and after their operation
· have an antigen swab test 48 to 72 hours before their surgery
· have a temperature check when they arrive on the day of their surgery
Staff working in the green CP zones will also complete a self-screening questionnaire and have a temperature check before starting each shift.
By restricting movement, adhering to strict IPC procedures and carrying out additional pre-assessment patient checks, we are making the green CP zone as safe and as Covid-19 free as we possibly can.
We will be increasing our surgical capacity for planned care slowly each week and reviewing our processes at every step, making any necessary adjustments to ensure patients can be treated and staff can work as safely as possible.
In addition to restarting elective surgeries at KGH, we are exploring whether or not we can continue to use the Independent Sector Treatment Centre (ISTC) at KGH beyond June and we will also continue our partnerships with Spire Hartswood, Spire London East, and the Holly. We have been using these private hospitals to treat our most vulnerable patients and those requiring urgent cancer or trauma services during this pandemic, when access to our own hospitals has not been possible because of the number of Covid-19 patients we were treating.
No Going Back
As you can imagine, achieving what I have described above will be no mean feat, but we will manage to do it because of our extraordinary staff. We have been capturing their response to recent months and the changes they’ve undergone in their working practices in a video and in interviews we’ve carried out with some of them. I would really recommend you take the time to read this account by Ed Bettany of his experience. It is for Ed, and for all our staff, that I am determined not to squander what we have achieved, in the face of considerable difficulty, and it is why we have written up our thinking in our No Going Back delivery programme.
Pioneering Senior Intern scheme broadcast on BBC One Daytime
We’re delighted the work we’ve done to improve dramatically our retention of our nurses has been filmed by the BBC and will be broadcast all this week at 10am on BBC One. If you miss any of the episodes you can catch up with them on the BBC iPlayer.
Support of West Ham
I’m really pleased our local team has decided to support us as we navigate the difficult months ahead. They will work to raise awareness of our charity and help them with some of their fundraising initiatives. We have many Hammers fans among our patients and staff and the team’s left-back, Aaron Cresswell made a video call to some of them recently.
As always thank you for your ongoing support and I hope you and your families stay well.