COVID-19 Update 10

Medical and Nursing Update

Today I have key messages and attachments from our Medical Director, Dr Adeyemo, and our Director of Nursing and Quality, Kenny Laing.

• Supporting our junior doctors
• Clinical Professional Advisory Group
• Practice Education
• Maintaining the Ward Community

Jonathan O'Brien - Director of Operations and Deputy Chief Executive

Supporting our junior doctors

During these unprecedented times, the industry, dedication and professionalism of our junior doctor trainees and staff grade colleagues has never been more important and our Medical Director, Dr Buki Adeyemo and Executive Director of Nursing and Quality, Kenny Laing, have extended our grateful thanks to them all.

We are mindful that the national and local picture is rapidly evolving so that prompt, accurate and useful update guidance is essential in ensuring that we safeguard our service users, our colleagues, ourselves and our families.

While recognising that guidance will be likely to change in response to developments, we have confirmed the current standards and practice requirements relating to on call duties, covid-19 specific patient care and managing their own health.  Full details are now available on CAT.

Clinical Professional Advisory Group

The Clinical Professional Advisory Group (CPAG) forms part of the Trust’s Emergency Preparedness Resilience and Response (EPRR) to the COVID-19 pandemic and is the senior Clinical and Professional Advisory Group for the Trust in relation to COVID-19. The CPAG will provide advice and respond to requests for advice from the Trust Incident Management Group.

The purpose of the CPAG is to offer expert clinical and professional advice to the Incident Management Group to inform decision making relating to COVID-19 Emergency Planning and Business Continuity. This advice will seek to use and disseminate the emerging evidence base for the management of COVID-19 in mental health and learning disability settings and to consider ethical decision making in the clinical care of our patients.

CPAG will be chaired by Dr. Buki Adeyemo (Medical Director and Deputy Chief Executive) with representative clinical membership from all Directorates and core professional groups

The CPAG will support the Trust’s response to the COVID-19 pandemic by:

• Offering expert clinical and professional advice to the Trust Incident Management Group to inform decision making relating to COVID-19 Emergency Planning and Business Continuity.
• Reviewing, disseminating and where necessary drafting Standard Operating Procedures (SOPs) for clinical aspects of care relating to COVID-19, with due consideration of the most up to date guidance and evidence.
• Advising the Trust Incident Management Group on new and emerging clinical evidence and practice relating to COVID-19.
• On a case by case basis, considering ethical issues and individual cases that are complex and sit outside the SOPs that are in place
• Providing a forum for staff to raise clinical issues of concern.

Practice Education 

As a Keele University Teaching Trust, we also set great store by our strong reputation for delivering the very best Practice Education.  We have also produced guidance and advice in relation to our Student Nurses, AHP students and Trainee Nursing Associates.  This can also be found on CAT.

Our Student Nurses will be given the option to work as a HCSW, possibly via the bank. The Practice Education Team and HR are currently reviewing how this could be expedited quickly.
 
Plans for Year 3 students to enter practice as band 4 nurses are being developed in line with Nursing and Midwifery Council Covid 19 plans).  This is purely a voluntary initiative and we are liaising with Keel University over who might like to take up this option. The Practice Education Team will be supporting this and are currently reviewing training and supervision requirements.

The new Trainee Nursing Associates uptake for March 2020 cohort has been postponed until September 2020.  All other TNA cohorts from Staffordshire University are continuing with their studies and have allocated study days and have been asked to return to their hub placement (unless otherwise agreed).

The Practice Education Team would like to thank all placement support teams for their ongoing commitment to students and trainees. The Practice Education Team can be contacted on: 07711189190

Maintaining the Ward Community

Finally, I thought you might find the following advice from the Royal College of Psychiatrists interesting, regarding 'keeping the inpatient community together'. The guidance is in direct response to the Covid situation and acknowledges the need to ensure social distance but also ensure that we minimise boredom.

Every ward is a community of people – staff and patients. As much as possible, this community should work together to best ensure the safety of everyone. But we cannot expect “business as usual” at this time. Each ward will have to find a way to focus on physical safety and infection control as the main priority. Key to managing this will be ward cohesion, communication and adapting as a community within local services

• Inpatient wards treat people whose mental health needs cannot be met in less restrictive settings out of hospital. The present situation gives an added dimension to this decision and teams, patients and families will need to work together to best protect the ward from COVID-19 infection.
• Many of the familiar routines associated with ward care will need to be reviewed. All activities that bring people into close contact will need to stop altogether or be adjusted to meet national guidance. Ward groups, ward rounds, mealtimes and visiting times should all be reviewed to allow for as little contact as possible. It is anticipated that much of this routine will be postponed on wards for the foreseeable future
• However, removing all ward activities is likely to be counterproductive. People who are restricted can become bored and agitated and require restraint or other restrictive practices. Wards should consider adapting communal activities to reduce duration, unnecessary attendance and increase personal space. Activities such as mindfulness/relaxation groups, dancing/exercise, karaoke and 1:1 meetings can all be done whilst maintaining the recommended two metre distance. Any such activity will have benefits in keeping up staff and patient morale and increase ward cohesion.
• Each ward community should work on keeping communication between staff and patients as good as possible through notice boards, written communication, smaller group or individual meetings and even text and digital messaging within the ward. As stated, meetings can still be carried out provided personal contact is avoided and adequate distancing is able to be maintained
• Latest government and national guidance should be easily available to all and the whole ward encouraged to stay informed of the situation as it develops. Staff should be clear about rules that are being imposed from national advice and that must be followed by all. Staff should always also model this advice
• Patients are active agents on wards and should be included as much as possible in assisting in the restructuring of activities and ward routines. Many can and should advise on what they need to stay informed and be included in decision making
• It is anticipated that there will be high levels of anxiety in the present situation. Good mental healthcare staff are highly skilled in the management of anxiety, both their own and other peoples. It is important to remain confident in your ability and ensure that principles of mutual support and team cohesion remain a cornerstone of your care.