Edition 2 - 16 May 2020

Dear colleagues,

Welcome to this second edition of our update which shares news and information on COVID-19 work across community health services, hospital discharge and social care and highlights initiatives in related areas.

Thank you to the health and local authority teams who have worked together to safely support people home or into other care settings over the last weeks; this has resulted in freeing up thousands of beds in hospitals to provide the capacity to keep others safe. This has only been achieved through the commitment of those providing the care and support to  enable people to stay safely at home – care home and home care providers, volunteers and family carers. Thank you to you all.

As everyone is working at pace to meet the challenges of the COVID-19 pandemic, we will continue to provide guidance and to respond to the questions and issues facing systems through regular webinars, “virtual clinics” and FAQs. Please also look to your regional teams for local support.

We have heard from people working in the community health and social care sectors that they are receiving information from a range of sources. This is inevitable as responsibilities cut across a number of national bodies. Our partners at DHSC have now launched a new web page which brings together national COVID-19 guidance for social care, and, additionally, I hope that this update will help to join up some of the messages and demonstrate that we are working closely across our organisations.

As a last point, please can you focus energy on filling in the Capacity Tracker for hospices, care homes and community rehabilitation wards - a critical tool for identifying capacity across the country.

Kind regards,    

News and Updates

Second Phase of NHS Response to COVID-19

Simon Stevens, NHS Chief Executive and Amanda Pritchard, NHS Chief Operating Officer published a letter on 29 April outlining the second phase of NHS response to COVID-19.

The letter includes details of how NHS organisations must also continue to partner with local authorities and Local Resilience Forums (LRFs) in providing mutual aid with our colleagues in social care, including care homes. This includes:

• Continuing to ensure that all patients safely and appropriately being discharged from hospital to a care home are first tested for COVID-19; care homes can also check that these tests have been carried out.
• Under the direction of the LRF, local authority public health departments and CCG infection control nurses can help ‘train the trainers’ in care homes about PHE’s recommended approach to infection prevention and control - particularly focusing on those care homes that lack the infrastructure of the bigger regional and national chains.
• To further support care homes, the NHS will bring forward from October to May 2020 the national roll out of key elements of the primary and community health service-led Enhanced Health in Care Homes service. 
• Opportunities to support care homes should also be provided to younger health professional ‘returnees’ and public volunteers who have offered to help (subject to appropriate personal risk assessment, as described above).

All NHS local systems and organisations working with regional colleagues fully are asked to step up non-COVID-19 urgent services as soon as possible over the next six weeks, including those set out in the Annex. Read the letter in full.

COVID-19: Care home support package

A letter published on 14 May from Helen Whately MP, Minister of State for Care, announces the new Infection Control Fund – £600 million to support adult social care providers to reduce the rate of transmission in and between care homes and support wider workforce resilience. This will be allocated to Local Authorities and is in addition to the funding already provided to support the Adult Social Care sector during the COVID-19 pandemic. The letter also introduces the support package for care homes building on the Adult Social Care Action Plan. The package sets out the steps that must now be taken to keep people in care homes safe, and the support that will be brought together across national and local government to help care providers put this into practice.

COVID-19 Response: Primary care and community health support for care home residents

Following the letter published outlining the second phase of NHS response to COVID-19, NHS England and Improvement will continue to share information in the coming days on how this will impact primary care services. In particular, they have published a letter  (1 May 2020) asking primary care and community health services to help provide the best possible care for our care home residents at this difficult time. They have asked CCGs, working with primary care and community providers, to ensure:

• timely access to clinical advice for care home staff and residents
• proactive support for people living in care homes, including through personalised care and support planning as appropriate
• care home residents with suspected or confirmed COVID-19 are supported through remote monitoring – and face-to-face assessment where clinically appropriate – by a multidisciplinary team (MDT) where practically possible (including those for whom monitoring is needed following discharge from either an acute or step-down bed)

COVID-19 Response: Identifying a clinical lead for all care homes

A letter published on 12 May has asked Clinical Commissioning Groups (CCGs) to identify a named clinical lead for each CQC-registered care home in their area by Friday 15 May. This clinician will provide clinical leadership for the primary care and community health services support to the care home, and is responsible for the co-ordination of the service provision set out in the 1 May letter. 

Priorities for testing include essential workers and care homes

On 23 April, the Government announced that all essential workers in England and members of their households who are showing symptoms of coronavirus will now be able to get tested (see the full list of essential workers). Booking the test has been made simpler via a new online system; essential workers can enter their details and will receive a text or email the same day inviting them to either book an appointment at one of more than 30 drive-through testing sites across the country or receive a home testing kit.

Additionally, the information relating to priorities for testing has been updated which means that, alongside testing patients to inform their clinical diagnosis and essential workers, they are also testing social care workers and residents in care homes (with or without symptoms) both to investigate outbreaks and, following successful pilots, as part of a rolling programme to test all care homes.

Find out more about the guidance on coronavirus testing, including who is eligible for a test, how to get tested and the different types of test available on the Government's website.

Expansion of patient testing for coronavirus to all non-elective patients requiring an overnight bed

As more test capacity has been made available, Ruth May, Chief Nursing Officer, and Steve Powis, National Medical Director, have asked hospitals to expand testing to all non-elective patients admitted into their organisations that require a bed overnight. This has come into effect from Monday 27 April and includes patients who are asymptomatic and those being admitted to community bed settings. This will enable hospitals to make preparations to cohort patients as possible COVID cases who need to be admitted whilst they await a test result. Appropriate infection prevention control recommendations must then be followed. A similar approach will soon be applied to elective patients.

Priority medicines for palliative and end of life care during a pandemic

The priority medicines for palliative and end of life care during a pandemic  clinical guidance, published on 30 April, aims to support healthcare professionals working in palliative and end of life care across hospital, community, social care and hospice settings to work together in managing additional demand on end of life medicines due to COVID-19. It sets out the first and second choices for these medicines, will enable the NHS to conserve supplies, switch to alternatives drugs when required and minimise waste. This is also being used to guide the purchasing of medicines for the UK. The guidance is supported by the standard operating procedure for running a medicines re-use scheme in a care home or hospice setting. 

Call for providers of community rehabilitation beds to sign up for the capacity tracker

The COVID-19 Hospital Discharge Service Requirements guidance requires care homes places, NHS community hospital beds and hospice beds to be recorded on the Capacity Tracker.  If you are a provider of a community rehabilitation bed, you must register and update it regularly to ensure a clear understanding, locally and nationally, of bed capacity and other business information. The data from the tracker is vital for local, regional and national efforts to support discharge planning and to understand the status of care homes and hospices - your support in this area will help us achieve this.

NHS Volunteer Responders Scheme 

550,000 individuals have signed up to be NHS Volunteer Responders and are helping thousands of people every day. NHS Volunteer Responders can undertake tasks such as:

• collecting and delivering shopping and other essential supplies
• delivering medicines from pharmacies
• driving patients to appointments
• bringing them home from hospital
• making regular phone calls to check in with people isolating at home
• transporting medical supplies and equipment for the NHS.

To refer your patients to the volunteer scheme, visit goodsamapp.org/NHSreferral or call 0808 196 3382. Continue to make use of your local schemes where they exist and please talk to your patients if in doubt about whether they require support. 

A helpful practical guide with some tips for health and care professionals to make the best use of the NHS Volunteer Responders scheme is available here.

Sam Sherrington, Head of Community Nursing NHS England and NHS Improvement, has blogged for the Queen's Nursing Institute (QNI) on the scheme and the role it can play in helping healthcare professionals support those who are clinically most at risk from the impact of coronavirus, or who are vulnerable in our communities.

Safety and speaking up during the COVID-19 emergency: Chief Inspectors statement

The three Chief Inspectors and the National Guardian of the NHS have released a statement regarding the COVID-19 emergency. The statement focuses on the importance of speaking up about anything that may get in the way of good patient care during this pandemic and ways in which you can do this. You can read the statement here.

The power of a post: Facebook request connects nursing home residents with pen pals from across the world

 A care home in York has found a new way to keep residents feeling positive and connected during social isolation, having made new connections with people from across the globe - all from a single Facebook post.

Elizabeth Hancock, owner of the Fulford Nursing Home asked local people to write letters to the nursing home residents, to help them to feel positive and connected. Incredibly, they were also flooded with e-mails, letters and gifts from all over the world. (Precautions are taken to ensure the letters and gifts are safe before being passed on.)

Elizabeth commented: 

"The response has been brilliant - we would like to express our thanks to everyone who has responded. I would really encourage other care homes to take up this idea - it was only a small thing to post, but it's made a huge difference to the lives of our residents".

For more information, visit their website.

Workforce Resources and Useful Links

​New landing page for social care guidance

A new landing page has been created on the gov.uk website, bringing together COVID-19 guidance published for the social care sector and other relevant documentation. Guidance on the page includes Admission and Care of People in Care Homes and the Ethical Framework for Adult Social Care, amongst others.

Webinars, Virtual Clinics and the Better Care Exchange​

The Better Care Exchange platform continues to be an important tool when looking for COVID-19 discharge and social care related content. Registration details for webinars and virtual clinics are also on the platform and updated regularly. There is also a designated discussion forum on the Exchange to facilitate shared local discussions. To register for the Better Care Exchange, please email us.

Health and Wellbeing - free support available for frontline health and social care staff

The wellbeing of all staff coping with the COVID-19 incident is of the upmost importance.   A package of resources made available to NHS staff was recently announced as part of the #OurNHSPeople. 

Now a new range of support and resources, open to all frontline health, care, emergency and key workers, curated by Mind and its partners, has become available - Our Frontline offers free round-the-clock one-to-one support, by call or text, from trained volunteers, plus resources, tips and ideas to look after mental health during the incident.

Training and development – resources from Skills for Care and Health Education England

As part of their response to COVID-19, Skills for Care have prepared a programme of essential training that will be useful for social care organisations and staff, including training for volunteers, existing staff, rapid induction of new staff, and training for staff who are being redeployed.  Access to training is secured through a network of accredited providers and support for funding is available.  Some detailed FAQs have been developed by Skills for Care to help you to understand the offer and how to access it.

Health Education England has also developed a COVID-19 e-learning programme for all staff responding to COVID-19.  The resources, which are being refreshed throughout the incident and include content relevant to staff working in community settings, are freely available to colleagues working in the NHS, independent sector, and social care.  Instructions on how to access the programme are available on the e-LfH website.

Resources for health and social care support workers 

This course contains e-learning and resources to provide health and social care support workers with the latest information and guidance on Coronavirus (COVID-19).

Resources for volunteers supporting health and social care

This course contains e-learning and resources to provide volunteers who are supporting health and social care with the latest information and guidance on Coronavirus (COVID-19).

Essential COVID-19 training and guidance

Skills For Care has identified training that remains a priority during this period to ensure there is a skilled and competent workforce.