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Case studies - supporting the NHS during COVID19

Independent healthcare providers have been playing a key role in supporting the NHS during the coronavirus pandemic and helping ensure that patients get the care they need in these most challenging of times.

This includes the recent historic deal whereby independent hospitals have put virtually all their capacity at the disposal of the NHS in responding to coronavirus, as well as an agreement for all independent sector CT scanning capacity to be used by the NHS support the accurate diagnosis of covid19.

Below are just some of the examples of how independent providers are supporting the fight against coronavirus.

Further information on an indicative set of offers from a variety of our members to support CCGs and Trusts during the Covid-19 pandemic can also be found here.

Capita - supporting the NHS in tackling covid19

Date of publication: 27th May 2020

Capita have supported the NHS in a number of different areas throughout the coronavirus pandemic including:

• Expanding the workforce: Onboarding and vetting, including standing up 200 staff in 24hrs, to process 20,000 nurse returners to the NHS; reinstating retired/returning GPs on to the Performer List, and supporting 91 Capita healthcare professionals applying to return to the NHS
Managing and co-ordinating: Scheduling, management services and technologies for staff and volunteers, including Workforce Management solutions to ISS at the Nightingale Hospital in London
Rapid technology enablement services including deploying a remote working solution for GP remote access to Clinical Systems in Birmingham for 150 surgeries to date, and the same solution to 200 London 111 users.
Provision of existing and new digital applications and technologies including updating and adding to the national clinical triage system Capita deliver for NHS Wales, mass SMS to vulnerable people in Scotland, and reminders re 7th and 14th Day isolation rule via NHS 111
FERA testing facilities supporting the National Testing Programme, working with PHE, DHSC and Defra/ APHA to provide equipment and lab staff

Capita also supported Central London Community Healthcare NHS Trust (CLCH) to organise the first Covid-19 testing drive-through, assisted with the rapid response to set up bedded areas (within 48 hrs), organised deep cleans across multiple sites, set up ‘hot’ and ‘cold’ sites to control contamination. Capita also rapidly opened and closed sites as needed over a weekend, and supported co-ordination and distribution of PPE equipment, as well as accelerating deployment of over 1000 devices, along with Teams on an NHS platform, and rolled out video conferencing.

CLCH CEO Andrew Ridley said: “This is truly a great effort from everyone and its made such a difference to us being able to progress our business of caring during extremely difficult times. I’m enormously grateful to all of you for everything you have done to make these things happen.”

Elizabeth Hale, Director of Improvement in CLCH added: “The partnership is playing a significant role in enabling us to respond to the current crisis” and the Trust IT Director offered particular praise for the work done by a key member of Capita’s IT team to support them.

18 Week Support and Medway NHS Trust

Date of publication: 27th May 2020

Medway NHS Foundation is a single-site hospital based in Gillingham, Medway Maritime Hospital, which serves a population of more than 424,000 across Medway and Swale. Demand for endoscopy services was challenged prior to COVID-19, with 814 patients waiting to be treated and during the COVID-19 outbreak the waiting was growing by 60+ patients per week. Medway NHSFT and 18 Week Support had an established working relationship prior to COVID-19 and following the pandemic a new and innovative partnership with 18 Week Support to provide the clinical staffing and Care UK to provide ‘clean’ endoscopy facilities in a separate location was created, allowing all to work closely together to address the rising backlog and minimise risk of cross infection by COVID-19. The partnership enabled each team to provide the different elements needed to build a successful system. From 15th April until 7th May, 38 Endoscopy sessions took place with 159 Patients Treated.

Paula Tinniswood, Medway NHS Foundation Trust “At the onset of Covid, Medway Foundation Trust was already working collaboratively with 18 Weeks Support and the Will Adams Treatment Centre (Care UK), to manage significant referrals for endoscopy. With the abrupt cessation of all but very urgent endoscopic diagnostics across the NHS, Medway Leadership decided to explore the feasibility of
continuing the existing partnership arrangements, which would support patient care at a cold site location. Robust clinical governance was developed by Dr Matt Banks and the Upper and Lower GI consultants at MFT. In the spirit of true partnership working, all Stakeholders were asked to sign and
authorise the pathway, which included Covid Swabbing, PPE usage and triage against criteria. Ultimately, this approach ensured that Medway patients, who were on 2ww Cancer pathways, continued to be seen in a safe manner.”

The McIndoe Centre & Queen Victoria Hospital (QVH)

Date of publication: 21st May 2020

The McIndoe Centre in East Grinstead has been working in close coordination with Queen Victoria Hospital (QVH) to support the NHS through the Covid-19 crisis, allowing hundreds of patients from across Kent, Surrey and Sussex to receive vital cancer surgery at QVH.

The McIndoe Centre, which specialises in plastic, reconstructive, ophthalmic and maxillofacial surgery, has helped provide capacity for QVH to become the regional cancer hub for breast, skin and head and neck cancers.

An arrangement was made at the beginning of April for The McIndoe Centre, which is part of Horder Healthcare, to treat patients suffering from maxillofacial and plastics trauma. A phased approach was implemented to reach the full service, which to date has seen a total of 309 theatre admissions, 185 minor operations and 273 outpatient follow ups. The McIndoe Centre is also treating urgent eye conditions.

Surgeries have been performed in The McIndoe Centre’s theatres, with one theatre available 24 hours a day to ensure limb threatening injuries can be treated immediately. Minor operations have taken place in the treatment rooms on an outpatient basis. The medical and anaesthetic teams consist of QVH staff. Theatre, ward and outpatient teams are a combination of The McIndoe Centre and QVH staff working together.

Major case plastic surgery reconstructions have also taken place, some even involving surgery techniques pioneered by the Centre’s namesake, Sir Archibald McIndoe, the visionary plastic surgeon who treated injured servicemen in World War II.

 

Nuffield Health Plymouth & University Hospital Plymouth NHS Trust

Date of publication: 1st May 2020

Nuffield Health’s Plymouth Hospital is currently hosting University Hospital Plymouth NHS Trust oncology department and is treating NHS patients undergoing cancer treatment, freeing up capacity for the NHS Trust to care for people showing Covid-19 symptoms, and shields vulnerable cancer patients during the pandemic.

The Trust’s oncology department moved into the Nuffield Health’s Plymouth Hospital on Monday 6th April after an intensive, fast-paced relocation project. This saw Nuffield Health’s Hospital set-up with the essential medical equipment, pharmaceuticals, IT network capabilities and clinical governance collaboration implemented to run the NHS oncology department safely and effectively for cancer patients. Before the move took place, Nuffield Health’s staff, both clinical and non-clinical, received essential oncology training within a week to ensure all staff were upskilled appropriately.  The training was successfully achieved through a unique collaboration between Nuffield Health, UHP, Mustard Tree Macmillan Centre and St Luke’s Hospice Plymouth.

Sian Dennison, Head of Nursing Cancer and End of Life, and Sarah Flavell, Cluster Manager Oncology and Haematology, from University Hospitals Plymouth NHS Trust, said: “In this current pandemic and a time of great challenge, anxiety and stress to patients and staff, it’s with great pride we have watched teams of staff come together and united continue to deliver the best care and service to our patients. We have watched them smile, laugh and work incredibly hard to set this service up quickly and efficiently. Thank you to everyone who helped make this happen from transport teams, porters, cleaners, to clinical and non-clinical teams across all providers.”

Patricia Warwick, Hospital Director at Nuffield Health Plymouth Hospital, says: “The situation we are experiencing right now in healthcare worldwide is extraordinary, these are untrodden paths and it’s fantastic the independent sector and the NHS can come together in the interest of public health.  We are doing all we can to support Derriford Hospital, from sharing our employees and a large section of our hospital to ensure that the oncology services can continue to be run in a safe and effective environment, whilst ensuring that Derriford Hospital frees up capacity and is best prepared to care for and treat COVID-19 patients.

“The oncology training that all my staff received was first class and I thank all parties involved for moving so quickly. Our theatres are now set up for chemotherapy patients, our ward is taking in oncology inpatients, we have set up an oncology outpatients department, ensured that a CT scanner in onsite, adapted our pharmacy, phlebotomy service and all our administrative and reception services to ensure they are best equipped to support the NHS.”

 

 

BMI The Park Hospital and Nottingham University Hospitals NHS Trust

Date of publication: 18th May 2020

BMI The Park Hospital transformed into a specialist cancer centre over the course of a weekend and has now treated around half of Nottingham’s total of 700 cancer patients who needed surgery during the Covid-19 pandemic, working as an extension of Nottingham University Hospitals NHS Trust.

BMI The Park Hospital has adapted its high-dependency unit (HDU) capacity in order to provide a full support to the NHS, transforming a recovery suite to an expanded HDU and thus increasing beds from an original five to 12 in order to accommodate patients with the most complex needs in Nottingham. Up to 20 operations have been completed every day, including operations for people with breast cancer, kidney cancer, liver cancer, pancreatic cancer, throat cancer, thyroid cancer and bowel cancer.

The increased HDU capacity at The Park has enabled NUH to allocate its own HDU capacity to treating Covid-19 patients, also leading to a geographical separation to shield cancer patients from Covid patients.

Cancer lead for Nottingham University Hospitals NHS Trust Mr James Catton said: “We need HDU beds in order to provide surgery for the most complex cases. We already had HDU expertise, but the limiting factor was the number of HDU beds. Over the course of a weekend – on Friday it was a recovery ward and on Monday it was an HDU – BMI The Park was turned into a cancer hospital. That foresight, the willingness to change, the established HDU expertise and the supplement of junior staff, anaesthetic cover and NHS staff working alongside Park teams has allowed us to transform BMI The Park into arguably the largest HDU outside London, enabling us to work on the most complex cases.”

Transform Hospital Group & NHS Worcester Health and Care Trust

Date of publication: 18th May 2020

The Transform Group’s Dolan Park Hospital has been proud to partner with the NHS in response to the coronavirus pandemic and has completely repurposed its services to help and support the NHS during this time. Dolan Park hospital has provided their ventilator capacity, in excess of their own current requirements, to the NHS for use in the Midlands and North West regions to support management of the infection peak. They have also partnered with NHS Worcester Health and Care Trust (WHCT) to take patients from their acute service who would ordinarily have been transferred to a community hospital once medically fit for discharge from the acute setting.

Together with NHS colleagues, Dolan Park worked to re-purpose the hospital in a matter of days to enable the facility to be ready, ensuring that pressure relief mattresses, mobility aids and aids to assist with daily living activities were available to enable patient comfort and safe rehabilitation. In just two weeks Dolan Park’s nursing and ancillary support team accessed essential training using key resources including e-learning for health, as well as engaging with training offered to us by our WHCT colleagues and experts, including modules on infection prevention and control, use of PPE and care of frail, elderly and end of life care patients.

Dolan Park has been able to offer patients nursing care and accommodation in single rooms, supporting social/physical distancing guidelines at all times. The whole team has adopted a collaborative approach to adapt to new working processes, with a focus on fast-paced consolidation of learning and cultural change displayed throughout the workforce.

 

Spire Southampton & University Hospital Southampton NHS Foundation Trust

Date of publication: 1st May 2020

A partnership agreement has been reached between University Hospital Southampton NHS Foundation Trust (UHS) and Spire Healthcare, enabling hundreds of patients with cancer to receive urgent treatment at Spire’s Southampton hospital, allowing UHS to focus on caring for people with COVID-19.

Spire Southampton has been working with staff at UHS to transfer Oncology and Haematology services to Spire. Since mid-March, more than 1400 NHS cancer patients have been treated at the hospital, and around 100 patients are now receiving care every day for cancers including Gynaecological, Neurological; Ear, nose and throat; Gastrointestinal / colorectal; and urology. Spire Southampton are also supporting time-critical Cardiac and Lung surgery for NHS patients.

Paul Grundy, Consultant Neurosurgeon and Acting Medical Director at UHS, said: “It became very apparent early on we would not be able to deliver all of the urgent procedures patients required at a time when we were building up to high volumes of patients with COVID-19 infection.

“We’ve been very fortunate in Southampton that we have excellent relationships with our independent sector partners including Spire and that has seen them work very dynamically with us to enable new surgical lists and services at different sites in different locations very quickly.

“With Spire in particular we have been very lucky in that they have been able to deliver surgery of high degrees of complexity with six theatres running at this site alone and, without that support, we would not have been able to provide really important clinical work through this challenging period.”

Aspen Healthcare and NHS London

Date of publication: 4th May 2020

Parkside Private Hospital, located in Wimbledon, is part of the Aspen Healthcare Group and has been supporting St George’s Hospital during the Covid-19 pandemic to ensure that patients require time critical surgery they need. The hospital is being used as a step-down facility for ambulatory trauma cases, plastics and diagnostics for St George’s Hospital. Pre-screening assessments for admissions including chest x-ray, blood tests and swabs which have been carried out on a timely basis, allowing for a seamless referral pathway. Parkside Private Hospital has also released 7 of their anaesthetic ventilator machines to the NHS South West London Elective Orthopaedic Centre in Epsom, which is earmarked as a Covid-Centre. 40 clinical and non-clinical staff from Parkside have also volunteered to support the Nightingale Hospital.

Highgate Private Hospital in North London, also part of Aspen Healthcare has been working closely with Whittington Health NHS Trust to care for patients during covid19. Highgate’s Hospital Director and Matron quickly established effective communications with senior Whittington Trust colleagues with the creation of IT links between the two hospitals to enable Highgate Hospital beds to be set up as one of the Whittington’s ‘wards’ on their Patient Administration System portal, allowing post-operative orthopaedic patients being admitted to Highgate. Daily outpatient space has also been created for immune-supressed patients to receive biological infusions, as well as a regular Parkinson’s Falls Clinic. Highgate have sent also sent 30 clinical staff to work on the Whittington wards to help care for frail elderly patients, many of whom have tested positive to Covid-19. This is a very different workload compared to the elective surgical work their clinical staff are used to, but they rolled up their sleeves to nurse these patients, even creating a WhatsApp Group entitled ‘HIGHWHITT’ to enable key individuals from both sites to communicate with each other regularly about shift patterns, training, challenges and solutions.

HCA - supporting the NHS deliver cancer and other urgent care

Date of publication: 1st May 2020

As part of responding to the coronavirus pandemic HCA have partnered with the NHS to support patient care. This includes treating existing urgent medical and surgical NHS patients to relieve pressure on the NHS and allow the NHS to treat more patients.

As part of this support, HCA are working with NHS partners in North London to care for maternity and urgent gynaecology patients at The Portland Hospital. Our colleagues at The Portland Hospital have been very busy and are proud to have supported the delivery of almost 100 NHS babies born at the hospital so far.

HCA are also working closely with Guy’s & St Thomas’ and King’s College NHS Foundation Trust to undertake urgent and complex NHS time-critical cases, and are part of London’s “Cancer hub” ensuring NHS cancer patients can still access the urgent treatment they need.

Diagnostic Healthcare - ultrasound services for urgent and DVT patients

Date of publication: 11th May 2020

As part of the Covid-19 national response, Diagnostic Healthcare (DHC) is working with a number of clinical commissioning groups (CCGs) to deliver community-based ultrasound services for urgent and deep vein thrombosis (DVT) patients.

Working in partnership with three CCGs – North East Essex, Cheshire and Walsall – DHC mobilised an ultrasound service at the beginning of April to service the network of GP practices in each area. Upwards of 1,000 appointments were made available to GPs who were able keep this essential service running. DHC’s patient services teams were available every day to field calls, ensuring patients had access to key information prior to their appointments. Clinical staff followed local GP practice protocols around building access, social distancing and the use of personal protective equipment to ensure patient and staff safety.

In the South Cheshire & Vale Royal localities of Cheshire CCG, the local hospital diverted Covid-19 free DVT patients into this service so they were able to maintain their capacity levels in urgent care. The GPs at Ashfield’s Primary Care Centre in Sandbach provide further treatment if needed as part of the community DVT pathway. This created a one-stop shop for patients and further efficiencies in the NHS system at a time of need. In North East Essex, the April figures showed that more than half of patients who were scanned needed further investigation or treatment which wouldn’t have been identified if the service had not been available.

Liat Karni, CEO of Diagnostic Healthcare said: “We are so pleased that we have managed to work with the NHS and support the CCGs during these unprecedented times by implementing a service which is so important as a non-invasive first line investigation. “

Pam Green, Chief Operating Officer for the NHS North East Essex Clinical Commissioning Group, said: “We are delighted to be one of the three CCGs that have worked with DHC on this initiative, which has helped allay the fears many DVT patients had about attending appointments at hospital during the coronavirus outbreak. Being able to take the service out into the community and run it from GP practices means not only do our patients feel safer, but it has also enabled us to reduce the burden on our acute services at a time when they face unprecedented challenges.”

Jamaila Tausif, Deputy Director Strategy and Partnerships, NHS Cheshire Clinical Commissioning Group said: “During an extremely worrying period for our Cheshire population we have been pleased to work closely with Diagnostic Healthcare to commission a Community DVT service during this unprecedented time. This service has ensured that DVT patients in our South Cheshire and Vale Royal locality have avoided unnecessary hospital attendances and therefore reduced the risks of contracting COVID-19. This service is a great example of partnership working between multiple organisations which has ultimately improved patient experience for our population in South Cheshire and Vale Royal whilst reducing the pressures on our acute hospital Urgent Care clinicians”.

Tina Cookson, Nurse Director South Cheshire & Vale Royal GP Alliance said: “Working with DHC and Ashfields Primary Care Centre to maintain our community DVT service and offer Urgent Non Obstetric Ultrasound Scans for GPs to refer into has enabled us to keep essential community services in place and avoid patients going to a hospital site unnecessarily. This has been good for patients and for the wider Health and Care system”.