Agenda item

This report provides the Committee with an update on the latest position with regard to the Covid-19 pressures facing the Trust.

Discussion:

Members considered a report which provided the Committee with an update on the latest position with regard to the Covid-19 pressures facing the Medway NHS Foundation Trust.

The Chief Executive of the Trust gave a verbal update on the latest position. Thanking the Council for the support it had given the Trust over the last few months, the Chief Executive reported that the hospital had been very busy since November. At the peak of the first wave in the Spring of 2020 there had been 150 people admitted who had tested positive for Covid-19. The figure for the peak of the second wave was 300, which had been exacerbated by the usual winter pressures. 50% of the main bed base hosted patients with Covid-19. Demand for intensive care services was high and some patients had to be moved to hospitals in other parts of the country. It was very rare to do this and patients were brought back to Medway as soon as it was possible and safe to do so.

The Chief Executive paid tribute to the workforce who had worked tirelessly over the last 12 months. Lateral flow tests were available for staff, who were encouraged to test themselves twice per week. PCR tests were used where staff tested positive. There was now more capacity to test patients, and all were tested prior to admission and routinely during their stay.

The hospital had been re-designed into zones to manage elective and cancer care and to help prevent the spread of infection. For infection control reasons and capacity to care for Covid patients, the majority of elective care had been paused but some cancer care was still being provided.

When patients were discharged to nursing or care homes the vast majority were tested first, in line with national requirements.

The hospital’s vaccination programme had started on 17 December and 5,000 vaccinations had been carried out, with staff working from 8am-6pm every day. The Pfizer vaccine was being used given the hospital’s ability to cope with the need for it be stored at -70 degrees C.

The Chief Executive thanked the local media for their continued support in publicising positive stories and emphasising positive public health messaging.

Members made several comments and asked the following questions:

·       Staff – several Members paid tribute to the work of everyone at the hospital in dealing with this pandemic. The point was made that, going forward, staff would need lots of support and could suffer from burn out.  Members were advised that staff sickness stood at 12% in December 2020 (it would usually be 3.5%) and was now around 7%. The Chief Executive had been concerned throughout the pandemic by the possibility of staff burn out and commented the experiences of staff could be likened to PTSD. The Trust was working on what support could be offered going forward and he was happy to report back to the Committee at a future date on specifics.

·       Accident and Emergency – whether there were still significant numbers of people with mental health problems presenting at Accident and Emergency (ED) and what could be done to improve the management of the ambulance area was questioned. The Chief Executive replied that  people with mental health problems who needed support routinely presented in (ED). The Trust had an excellent relationship with the Kent and Medway NHS and Social Care Partnership Trust (KMPT) and was able to access their services and have patients assessed in a reasonable time. The hospital had facilities where patients could wait before receiving treatment. The Chief Executive acknowledged some ambulances had to wait longer than he would like due to high demand. Key to this was reducing occupancy levels so beds were available and also continuing to work with the Ambulance Trust on dynamic conveyancing, whereby ambulances were temporarily diverted to other hospitals to balance demand.

·       Resilience of the system – the Chief Executive was asked what he thought needed to be prioritised for the Trust to be in a stronger position to cope with another pandemic in the future. The Chief Executive replied that reviews would look at what had worked well and what could be done better and this would be done in context of the Integrated Care Partnership to decide what measures introduced during the pandemic  should be retained. Staff availability had been a critical issue for the Trust and he considered that the offers of help that had been made during the pandemic by partners should be formalised as the basis for a future pandemic plan.

·       Hospital zones – how successful the new zones referred to by the Chief Executive were was queried, including how many people had contracted Covid-19 while in hospital. The Chief Executive explained that patients were clinically assessed before they were allocated a zone. Most patients admitted presented with Covid-19 symptoms and were placed in the red zone. Those whose test had been negative or inconclusive but had symptoms putting them in a higher risk group were placed in the amber zone. The green zone was for people who the hospital were confident did not have Covid-19. All patients were regularly tested and could move between zones where their status changed. There had been some cases of patients contracting covid in the hospital, mainly due to patient-to-patient contact. As a result, the infection control and testing regime had been enhanced and numbers of patients infected while in hospital had been very low since the end of November. This had also happened in other hospitals in areas of high transmission.

·       Lateral flow tests – in terms of the success of these tests,1.4% of staff had tested positive who would then receive a PCR test.

·       Vaccination programme – in response to a question about the split between patients and staff, Members were advised that the majority of people vaccinated (4,400) had been staff or people who worked on the site.

·       Cancer care – the Chief Executive commented that cancer care had been provided through the pandemic until recently. For infection control reasons, the independent sector was now being used for some cancer patients and for some elective surgery. There was a ring-fenced area of the hospital which was used where there was a risk of a cancer patient dying if they did not receive early surgery. More cancer patients would be brought into this area when possible, probably by mid to late February.

Decision:

The Committee thanked the Trust for their attendance, put on record their appreciation of the work of all staff during the pandemic and agreed to receive a further update in the future.

(In accordance with Council Rule 12.6, Councillors Murray and Price asked that their votes in favour be recorded.)