The Kent and Medway Clinical Commissioning Group is supporting all frontline services and providing a co-ordination and oversight role as the strategic lead for the NHS response to Covid-19 in Kent and Medway. This briefing provides a summary of how the local NHS is working to provide the best possible care to patients and save lives. Please help protect the NHS by following all the national guidance on social distancing. Stay at home. Protect the NHS. Save lives.
(figures provided are accurate at end of day Wednesday 01 April 2020)
Hospitals reducing bed occupancy to prepare for more Covid-19 cases.
Over the last week all local hospitals have been working with community and social care partners to discharge medically fit patients. Increased discharges have freed up over 1,000 beds out of a total of 2,600 across Kent and Medway. All hospital trusts have now brought their bed occupancy levels down to around 60%.This is allowing all hospitals to prepare additional beds to provide specialist care for Covid-19 patients in the weeks ahead.
Staffing sickness and self-isolation
All NHS services are reporting adequate staffing levels to maintain priority services, despite significant numbers of NHS staff self-isolating with symptoms or in households where another person has symptoms. Across Kent and Medway health services there are approximately 2,000 staff absent due to Covid-19, representing 7.75% of the workforce. This data does not currently include primary care.
Mental Health open access service
A mental health Covid-19 response team has been established as part of the NHS Kent and Medway incident response structure. The team is looking at developing 24/7 open access to crisis response teams with Kent and Medway NHS and Social Care Partnership Trust. This would be to support reduced demand on 111 and 999 services and to reduce attendance at emergency departments to limit risk of spreading Covid-19. The mental health Covid-19 response team is also developing a package of support for NHS staff.
Primary care treatment centres to separate symptomatic / self-isolating patients
This week NHS Kent and Medway CCG agreed new standard operating procedures with primary care networks that will see all networks develop what are often referred to as hot and cold sites for seeing patients who need a face to face assessment. This is to reduce the possibility of spreading the infection between patients coming to see GPs and their teams.
General practice teams are offering as many telephone and video appointments as possible to limit the number of patients needing to travel to be seen in person; but there will obviously still be times when people need to see a clinician face to face.
People without covid-19 symptoms will be seen at a cold site. People with symptoms or from a self-isolating household will be seen at a hot site. To ensure people are directed to the right location all primary care appointments are now pre-booked by phone with no walk-in or on-line self-booking.
Most of the 42 primary care networks across Kent and Medway are using their existing surgeries to separate hot and cold services. In a small number of cases models using temporary structures or other non-health sites are being developed, some with a drive thru model. These are not testing centres as some initial media reports suggested.
Personal protective equipment (PPE) – Kent and Medway central distribution
We know access to PPE has been a key area of concern. We are working hard to make sure staff on the frontline in NHS Trusts, primary care and other services such as care homes, hospices and home care providers have access to the right PPE for the work they are doing. The national guidance on PPE has been updated today [2 April 2020]
This week we are mobilising a central warehouse to supply all core services across Kent and Medway. The service is being managed by CCG staff and is working across health and care partners. Our new approach will bring all PPE supplies into a single point for Kent and Medway and then distributes it locally based on need. This will improve the speed of being able to resupply individual services through a local stockpile and prevent a situation of unused stock sitting in one location whilst another runs low. We are encouraging all local services to join the central service. The warehouse will also include 200 3D printers producing protective visors.
Staff testing
The Government has taken the decision to offer Covid-19 testing for NHS staff who are symptomatic. In Kent and Medway we are currently developing plans for a range of ways for staff to access testing. We will update on plans in a future briefing. More testing will staff who do not test positive for Covid-19 will be able to carry on providing patient care, whereas otherwise they would be required to self-isolate for seven days.