HSJ Weekly Catch Up: Wanted — PPE, GPs, ambulances and vets

A paws for thought

Ahead of an expected surge of covid-19 patients requiring intensive care in the next few weeks, trusts are doing all they can to secure enough staff.

Two trusts have turned to other sources to fill gaps. HSJ has revealed Torbay and South Devon Foundation Trust approached local veterinary groups asking for volunteers to become “respiratory assistants” who could act as ICU medics’ “eyes and ears”.

Further north, Hampshire Hospitals FT has created a “bedside support worker” role, which will include — among others — vets and dentists.

Meanwhile, it was inevitable that ambulance response times would suffer during the covid-19 crisis, not least because of the extra pressure put on services by an increasing number of calls.

But the size of the drop in performance in March was bigger than many had expected. Response times to category two calls —  which are those classified as an emergency but not immediately life-threatening — jumped to 32:06 minutes in March compared with 22:07 minutes in February and against an 18-minute target time. 

Ambulances are not the only thing in demand. With covid-19 deaths in the England now sadly in the thousands, the crisis also means more body bags are needed and trust procurement leads are scrambling to locate more, as central supplies run short.

Although Public Health England says body bags aren’t needed to transport deceased covid-19 patients safely, it accepts there might be “practical” reasons for using them. 

The tech solution

The coronavirus crisis has sparked a rapid rollout of new tech across both primary and secondary care. 

In recent weeks, there has been a spike in the uptake of technology that allows NHS staff to draw down a proportion of their wages immediately after a shift.

Wagestream and Earnd are among the providers that have offered their services to the NHS for free since the covid-19 outbreak, to help ease financial anxiety among the workforce. The technology is being used with NHS staff on lower paygrades in mind. 

Meanwhile, local NHS systems deserve huge credit for the agility they have displayed in speedily reconfiguring services in response to the coronavirus outbreak.

The new Nightingale hospitals are good examples of this. But, as our bureau chiefs James Illman and Lawrence Dunhill argue here, is there a case to reconfigure the care model being used in London?

The out-of-towners

Last week, it became apparent there were no plans — or at least no immediate plans — for a Nightingale hospital in the south east. This week, it transpired the plan was to treat a number of patients from Kent and Sussex in London’s Nightingale in the repurposed Excel Centre. 

But there is a sting in the tail for trusts who want to transfer patients there. They will be asked to provide staffing: for every eight patients transferred, trusts will be asked to provide a nurse and support worker.

Meanwhile, some maternity inspections have been suspended in a bid to help trusts focus on covid-19 pressures.

The Healthcare Safety Investigation Branch has announced it will pause routine investigations into maternity incidents involving babies treated for oxygen deprivation at birth, but with no apparent brain injuries.

Use with caution

After weeks of shortages and urgent calls for action on personal protective equipment, adult social care and other community services are set to receive some 30 million PPE products via their local resilience forums and the military.

But the supplies come with a caveat from health and social care secretary Matt Hancock and housing, communities and local government secretary Robert Jenrick: use with caution — only where there is “a clear and pressing need”.

Elsewhere, it’s not PPE that’s running short, but GPs.

A key component of NHS England’s remote triage by default policy is the national covid-19 clinical assessment service, designed to assess those patients which 111’s algorithm deems too seriously ill to continue managing their coronavirus symptoms at home without clinical intervention but not seriously ill enough to warrant an immediate trip to hospital.  

GPs assess patients over the phone and decide whether they are sick enough to head to hospital, can safely self-isolate without any further clinical intervention, or need help from their GP, either with proactive monitoring over the phone or with a face-to-face assessment.

However, according to a letter sent by NHSE’s primary care directors, the service “urgently” needs more GPs to staff it.