The following information was recently circulated to our Foundation Trust members. It outlines the changes we have made in our hospitals in recent weeks and explains how we plan to resume some of our elective services while keeping our staff and patients as safe as possible.
Bringing you up to date
At the start of the year we could hardly have imagined that so much would change in such a short time.
The way that our people and the NHS responded to the Coronavirus challenge was astounding and the transformation in our services unprecedented.
Here we outline those major changes, update you on the current situation and describe what to expect in future.
The changes we have had to make have impacted on everything that we do in relation to our patients and our staff. They include:
- Implementing our Trust-wide emergency incident command structure from March onwards, led by Gold Commander Dr Bill Jewsbury, co-ordinating the changes we make in line with regional and national strategy
- Doubling our intensive care capacity to 48 ventilated beds and the option to further double capacity again if we had needed it
- Scaling back as much non-urgent elective, diagnostic and outpatient activity as possible to focus on the potential surge in patient numbers
- Redeploying and retraining hundreds of clinical staff to care for Covid-19 patients
- Creating separate Covid-positive and Covid-negative areas and pathways within our hospitals, including in our emergency departments, to minimise infection
- Shielding our most vulnerable staff and enabling hundreds of staff to work from home to reduce the infection risk for both them and our patients
- Switching a huge number of outpatient reviews and appointments to video and telephone consultations, significantly reducing the need for many patients to come into hospital
- Stopping all visitors, apart from in exceptional circumstances such as a parent accompanying a child or a carer for a very vulnerable adult
How have we coped?
Good planning with a rapid and effective response from Frimley Health staff, combined with most people in the community observing social distancing and isolation, meant our services were not overwhelmed.
The initial peak is behind us, but we are experiencing a long ‘tail’ of cases that we expect to remain for months to come.
We have had unbelievable support from the community, and some of you will have read from our Fundraising team’s regular newsletters about the hundreds of letters of thanks and support, donations and other acts of kindness that have made a massive difference to our staff and patients.
All our staff, who have been through some of the toughest times of their careers in recent weeks, say what a huge difference it has made to their morale. Some of the money raised has provided support for staff and for patients, for example digital tablets that enable patients to stay in touch with loved ones who are not allowed to visit.
The Trust has been focusing on our colleagues’ welfare with a package of wellbeing and psychological support available to them around the clock. Some of the money raised will help to keep and develop these vital support services over the longer term.
The situation today
Thankfully the number of inpatients and new admissions from Covid-19 has fallen away significantly from the peak of mid-April but we don’t yet know how long it will be before we will return to anything like our previous activity levels for other services. Planning continues for a potential 'second peak' of Covid-19 infections.
By the end of last week, we had discharged almost 900 patients in total who had recovered from Coronavirus. We had about 80 confirmed Covid-positive inpatients, roughly a third of the number of Covid-19 patients we were seeing a month ago. Sadly, just over 350 patients in total have died across our hospitals after testing positive for the virus. Staff absence from illness and self-isolation was running at triple our normal staff sickness rate, but it is now getting better.
We are currently testing all patients on admission and again after 14 days if they initially tested negative. We are also testing all symptomatic staff and providing regular screening tests for staff who are working in our elective surgery areas in order to keep the risk of Covid-19 infection as low as possible.
Our emergency departments and other urgent services remained fully open throughout the first surge and will continue to do so. Patients are triaged and segregated to different zones to keep suspected Covid-19 patients separate from other patients.
However, the number of people coming to A&E has been about half that of previous years, suggesting that people are staying away because they are either concerned about the risk of infection or worried about putting pressure on services.
Please remember that you should still use emergency departments if you are concerned you are seriously unwell, or contact NHS 111 for advice. Our emergency departments are safe, and we would much rather treat you promptly than leave it too late. And if a child needs care, a parent or guardian will be allowed to stay with them throughout, with PPE if required.
Maternity departments, neonatal clinics and urgent paediatric services have also remained open and even at this difficult time we have had the pleasure of welcoming more than 2,000 babies into the world!
Some of you will know from our public message last week that we are restarting some of the services we had to put on hold. However, the challenges posed by Coronavirus are still very significant so we can only do this cautiously.
Because of this we will not be running anything like the full elective and diagnostic services that we have been used to for a long while yet. The NHS remains on an emergency footing and must be prepared to rapidly redeploy resources again in the event of a second surge.
If you are waiting for a procedure, we will contact you directly as soon as we can and you will be given specific advice about where to go and what you need to do.
Where possible, we will be using telephone and video to carry our patient consultations, avoiding you having to come into hospital to speak with a specialist.
If you are waiting for urgent treatment, such as for cancer, our clinical teams should have been in regular contact with you to provide information and support, but please do contact us if you have concerns.
We are taking great care to segregate elective services and to maintain good infection control. For example, we are using our Heatherwood Hospital in Ascot as a Covid-negative facility for surgery and endoscopy. Staff working there are regularly screened to protect patients and colleagues.
We have partnered with parts of the private sector to provide some services, for example endoscopy at Spire Clare Park near Farnham and BMI The Princess Margaret Hospital in Windsor for urgent cancer treatments.
We also want to make sure we maintain some of the service improvements that we have been planning, but which have been accelerated by the onset of Coronavirus, such as telephone and video patient appointments and more seven-day senior clinical leadership.
We have adequate PPE at the Trust to be able to provide our staff with the protection that they need for their own safety and that of their colleagues and patients. If you need to come to a hospital you will be advised if you need to wear PPE.
Other local heath and care organisations are also starting or planning for the resumption of some essential services, such as urgent GP appointments, outpatient follow-ups and support for mental health. The progress we have made in our Frimley Health and Care partnership has helped us work much more collaboratively in recent weeks.
We don’t yet know how long Covid-19 will be endemic in our communities, or whether we will see future surges or changes in the disease. Until this becomes clearer, we have to remain agile and flexible so that we can rapidly scale up Covid-19 services again should we need to.
Keeping in touch
The best way you can support us is by continuing to follow national guidance and taking note of changes and updates to advice. Maintain social distancing, wash your hands frequently and stay alert.
We will continue to update you with further relevant information about the Trust. The quickest and most efficient way of receiving this is via email, so please keep checking your inbox.
As you know, we have had to cancel all constituency meetings for the rest of the year. We are very sorry to do this as we know how popular they are. Until we can resume them, we are looking at different formats to provide you with information and presentations from your Governors, our clinicians and senior Trust managers.
We are constantly adding new information to the Trust website and providing further news, advice and updates on our social media channels, so please follow us on Twitter, Facebook and Instagram.
You may also find useful information, including how to access other local health services, from the following partnerships and organisations:
- Frimley Health and Care Integrated Care System
- East Berkshire Clinical Commissioning Group
- North East Hampshire and Farnham Clinical Commissioning Group
- Berkshire Healthcare NHS Foundation Trust
- Surrey and Borders Partnership NHS Foundation Trust
Thank you all for your continued support. It means so much to everyone at the Trust to know that you are with us.