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.

 

 

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.

 

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.

St Michael's Clinic - providing blood tests for "at risk" patients during covid19

Date of publication: 6th May 2020

St Michael’s Clinic – a specialist dermatology unit in Shrewsbury, which forms part of The Dermatology Partnership – has turned into a super cold centre to provide blood tests for ‘at risk’ people advised to shield themselves during the COVID-19 pandemic.

The new service has been rapidly introduced by St Michael’s Clinic, working with the local hospitals and community services, in response to the crisis to offer a safe environment for people who have been advised to stay safe by shielding themselves for 12 weeks. Many of these patients have continuing health needs and could face wider health risks if vital blood tests are missed.

A team of five trained nurses and a car park attendant will run the new service. When a patient arrives, they will be directed to a parking space and asked to stay in their car until the dedicated time slot becomes available, so no two patients arrive in the building at the same time.

Care UK Peninsula NHS Treatment Centre & University Hospital Plymouth NHS Trust

Date of publication: 30th Apr 2020

Peninsula NHS Treatment Centre in Plymouth have completely repurposed their service to help in the response to COVID-19. Working with the local NHS Trust (Universities Hospital Plymouth), their unit has gone from doing one core specialty to over half a dozen in the space of just weeks, including urology, ENT, general surgery, breast cancer surgery, plastic cancer surgery, plastic and orthopaedic ambulatory trauma, and vascular surgery. This also includes all outpatient pre-assessments and COVID swabbing of patients, with the Trust housing its Occupational Therapists, plastic trauma and dressing clinics, gynaecological clinics and vascular ultrasound clinics at the centre too. All this as well as running a MRI Scanner service and taking step down in-patients from UHP.

A truly hybrid model has been adopted, with surgery undertaken by Trust surgeons supported by Care UK’s theatre team and anaesthetists. It has been such a fantastic example of collaboration and the centre are so proud of how all teams have responded. Patients seem so pleased to have the opportunity to still have their surgery in spite of the pandemic – without the hard work and determination of everyone involved these patients would have had nowhere to go.

 

Ramsay Oaklands Hospital & Salford Royal NHS FT

Date of publication: 1st May 2020

Ramsay’s Oaklands Hospital have worked with Salford Royal NHS FT and are now hosting their Intestinal Failure Service, one of only two designated centres for the treatment of complex intestinal failure patients in the country. Substantial investment was required to ensure the service could be delivered from the new site, including the establishment of complex IT systems and installation of specialist equipment. This was successfully achieved at short notice and the first cohort of patients and staff were welcomed in to the hospital by the end of March. The Oaklands Hospital and the Trust continue to work in close partnership, including the facilitation of ‘lunch and learn’ sessions to support knowledge and information sharing about the services provided.

InHealth - repurposing community facilities to support the NHS

Date of publication: 1st May 2020

Very early on in the pandemic, InHealth took the decision to re-orientate their entire organisation to support the NHS to respond to the substantial challenge that is COVID-19, including:

NHS 111 service: At the request of the London Ambulance Service (LAS) InHealth has repurposed their 120-seat Patient Referral Centre in Rochdale to support them in handling COVID-19 calls to NHS111. The service we are providing to the LAS went live on 2nd April and now operates 16 hours a day, seven days per week. In the first few weeks we handled over 50,000 calls

Breast screening: InHealth’s Breast Screening service in Surrey is currently suspended however, working with local stakeholders, InHealth has repurposed their screening centre to now provide a diagnostic service for women in that region with breast cancer symptoms to allow the clinical pathway for those women to continue.

Hot-hub for COVID-19 patients: InHealth’s MSK service in Manchester is delivered from a Mobile Clinical Unit (MCU) which unit moves from site-to-site within Greater Manchester providing great accessibility for local MSK patients. At the request of Heywood, Middleton and Rochdale CCG, the unit has been repurposed to be a “hot-hub” for COVID-19 patients.

Care UK - NHS Buckinghamshire MSK Integrated Care Service

Date of publication: 30th Apr 2020

Prior to COVID 19, only a very small part of Care UK’s Buckinghamshire MSK services were delivered over the telephone (namely diagnostic results) and all assessments and treatments, were 100% face to face. However in April, of the 657 patients seen in just one week, 100% were seen and treated virtually by telephone/video consultation.

Of the new patients seen, circa 25% were treated by video consultation whereby clinicians can share their screen with the patient if they want to talk the through MRI or X-ray results, and show the patient their images. Video consultation enables the clinician to ‘observe’ the patient, which is a key part of an MSK assessment and use it to view ganglions, lumps and swellings, as well as to support assessment of range of movement, and potential muscle weakness in patients with radiculopathy. It has also been used to demonstrate exercise prescription, which is a large part of the self-management advice required for patients to be able to manage their conditions at home. This type of intervention is so important to enable patients to continue to be active and support / care for loved ones as well as helping to offload GPs in primary care to be able to support more medically unwell patients.