Firstly, I wanted to take the opportunity to thank all of our clinical teams in responding to the challenge of COVID19. I don’t underestimate the challenge of the changes which have been made in such a short space of time and how, incredibly, many of our teams have increased the support being provided to our service users and carers since March this year.
In keeping with many of the changes taking place in everyday life, we are now moving to the next stage of operating our clinical services in the context of a reducing prevalence of COVID-19 and a lower community transmission risk. This means I can inform you of what we can now do, specifically in our
community teams. This communication does not affect arrangements for corporate services or at Harplands Hospital site, for whom there are other processes in place.
Your teams should be in the process of completing your personal plans and the team based risk assessment of premises. For adaptations to premises, we will be prioritising CMHT teams in adult, CYP, older people and CDAS for any adjustments to make premises as COVID-secure as is possible.
As we do this work, I wish to stress a number of points in relation to how community teams can now operate as the prevalence and risk of COVID-19 transmission in our community is reducing:
- In person face-to-face assessments and care can be undertaken in community facilities for all service users when required.This includes urgent and routine cases of all ages where a physical face-to-face consultation would be preferential to a digital one. Digital video contact still remains our default preferred option if this method allows a safe level of assessment and care to be provided. When seeing service users in person, staff should adhere to social distancing guidance and if unable to do so utilise PPE in line with guidance on the COVID intranet page. PPE is available in all main community sites.
- Staff can use community facilities to work, providing risk assessments are completed for the premises and staff. Your team leaders and service managers will be able to inform you when this is complete. All staff should continue to adhere to social distancing guidance (2m) and utilise PPE (in particular a face mask) where social distancing is not possible.
- Continuing to work from home remains a perfectly good option for the majority of our staff and we would encourage staff to continue to do so where possible, This will continue to be agreed through line management structures and personal plans. It will facilitate social distancing within community
sites via fewer staff being present at once. Arrangements for the number of staff in individual sites at one time should be agreed at team level with reference to line and service managers, supported by Health & Safety and IPC.
- All teams categorised patients using a risk based approach during the initial wave of the pandemic and continue to do so. It is expected that all patients categorised as highest risk would now be receiving face-to-face reviews and interventions and this can be done via either digital means or in person.
- The Trust is recommending that all clinicians consider
the impact of COVID-19 and lockdown in all assessments and reviews. Clinicians are encouraged to openly discuss such issues service users under their care, recognising that recent events will have affected the lives and mental health of many of our service users.
- All discharges from inpatient care should be made using a CPA approach in line with Trust policy on care plans and fully involve home treatment and community teams as required. In particular, wards are asked to be vigilant to ensure community teams and families and carers are involved in all discharge plans.
In summary, there is
now no need for any of our service users to not be receiving the assessments, care or treatments that they need or are waiting for, providing we all take a sensible approach to personal and team based COVID-19 risks. This includes adherence to social distancing norms and the use of PPE when undertaking clinical activity where it is mandated or when social distancing cannot be maintained in the workplace.
Questions can continue to be directed via line managers or to covid.questions@combined.nhs.uk
Thank you for all
your ongoing effort and support to keep our service users and carers safe and well.
Jonathan O'Brien,
Deputy Chief Executive and Executive Director of Operations