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.”

 

 

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.

One Medical Group - supporting CCGs and Trusts during covid19

Date of publication: 6th May 2020

One Medical Group, a primary care provider, has been liaising closely with their local Primary Care Networks (PCNs) to help support patients and share best practice. In Sheffield, the Minor Injuries Unit co-located within the acute NHS hospital was closing so staff could be deployed into the main hospital to support with Covid-19 demand. OneMedicalGroup delivers a walk-in centre in the city centre and liaised with the acute hospital and CCG and offered to staff the MIU so it could remain open and reduce pressure on the emergency department. This offer was accepted and plans were mobilised in 24 hours. Equally, in Leeds, One MedicalGroup’s team of Adult Nurse Practitioners from their walk-in centre have been supporting with pressures in ED at St James’ Hospital and Leeds General Infirmary, as well as supporting the OOH services which are experiencing an increase in demand.

HomeLink Healthcare - supporting NHS Hospitals in Norfolk

Date of publication: 6th May 2020

HomeLink Healthcare is supporting their NHS partners in Norfolk through Virtual Ward and Early Supported Discharge services.

During February and March, creating capacity within hospital wards in preparation for the COVID-19 surge was a major challenge for already busy hospitals.  HomeLink Healthcare contributed to the re-configuration process by providing flexible capacity facilitating the early discharge home of patients, including those needing IV antibiotics at home,  as well as step down care before they can access social care services in the community.

As COVID-19 cases grew their services helped hospitals in Norfolk make best use of the limited number of ‘non-COVID-19’ beds. Providing home-based care for patients reduced hospital bed nights and avoided admissions, reducing demand on stretched resources and risk of cross infection.

As the recovery process starts there is a focus on the patients waiting for elective procedures. Many hospitals are operating with a reduced bed capacity as some wards have to be reserved for a second surge in COVID-19 cases. HomeLink’s services are helping make best use of available bed capacity by providing care for patients at home as soon as they are medically fit to be discharged.

 

 

Connect Health - delivering NHS physio during covid19

Date of publication: 7th May 2020

Connect Health is the largest provider of NHS Community musculoskeletal (MSK) services, including physiotherapy, chronic and persistent pain and rheumatology. Prior to Covid-19 Connect were delivering remote/virtual care to 200,000 patients per year, so were able to scale this capability rapidly to ensure that patients can still access the clinical care that they require.

In particular Connect have scaled up their virtual physiotherapy service and has also introduced a digital self-assessment tool – PhysioNow – which is part of their work to invest resources into ground-breaking AI technologies in order to improve accessibility and patient choice.

During the current pandemic many of Connect’s staff have been re-deployed to frontline services in NHS Trusts, and the new Nightingale Hospitals. This includes working in Rehab Teams on wards to enable people to be discharged home quicker or in physio roles in various other locations such as Neuro or Inpatient units.

 

 

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”.

 

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.

 

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.”

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.

 

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.”