Briefing 20 March 2020

East Lothian Health and Social Care Partnership COVID-19 Response

IJB meeting arrangements

We cannot convene East Lothian Integration Joint Board and Audit and Risk Committee meetings because of current public health restrictions. Therefore, in line with current guidance that we should have procedures for a decision-making process in place, we will:

  • Hold a virtual IJB meeting on 26 March 2020 by Skype – details to follow
  • Thereafter, update members with a weekly briefing.

Current position

All ELHSCP decisions follow advice from the Chief Medical Officer (CMO), Health Protection Scotland (HPS) and NHS Lothian Public Health. We are also consulting with all other Health and Social Care Partnerships, COSLA, NHS Scotland and the Scottish Government. Guidance changes regularly in response to the developing situation and may contradict/supersede current standards or legislative requirements. We have to be equally responsive.

ELHSCP cannot guarantee that service expectations and conditions will be satisfied always but we will strive to do the best for the people who use our services and our staff.  We will also ensure that our providers are not financially compromised during this difficult time. 

Key actions taken by ELHSCP services

Whole-system ELHSCP actions

  • Self-isolating staff are using appropriate technology to continue adjusted working where able.
  • We are moving towards cluster working, prioritising early discharges, prevention of admissions, and community crisis intervention.
  • We are reviewing staffing across all sites. Staff hours are being increased, where possible, and staff are being brought in from non-essential areas to carry out any required roles within their professional capabilities.
  • We are assessing availability of stocks to ensure adequate supplies for use in essential clinical areas.
  • We are focusing on critical response and, where possible, reviewing and priority-rating health and social care requirements. 
  • Workers will mainly be contacting service-users by phone and making home visits only where absolutely essential.

Adult Services Practice Teams

  • The Duty Team are the first point of contact but locality crisis teams will deal with emerging demands. We are setting up three (east, central and west) locality crisis teams, staffed by Occupational Therapists, Social Workers and Community Care Workers.
  • The Support Plan Broker Team (responsible for sourcing and purchasing care) is being augmented with Community Care Workers and administration staff.
  • The Care Home Assessment and Review Team will continue to be based at East Lothian Community Hospital.

Primary Care

  • ELHSCP will agree coordinated activity and share resources with Practice Managers as need arises.
  • ELHSCP teams are mobilising to create multi-disciplinary support in primary care.
  • Work is underway to increase use of on-line prescription requests.
  • All practices will have received personal protective equipment (PPE) by 18 March 2020.

Mental Health and Substance Misuse Services

  • We will focus on those clients needing a critical response. 
  • Contact will mainly be by phone, with high risk provision available at home or in Outpatient Department 2 at East Lothian Community Hospital.
  • The Monday afternoon Substance Misuse Service (SMS) drop-in clinic at East Lothian Community Hospital will continue to support our most chaotic and vulnerable service-users.
  • We are accepting referrals as normal, with teams screening/triaging on a daily basis.

Adult Resource Centres and Day Provision

  • We are suspending the provision of day facilities temporarily. This covers ‘day care’, ‘day hospitals’, the Adult Resource Centres and commissioned day services run by the Third Sector.
  • We have arranged with day centre staff and others to provide support to and monitor service-users to offset the effects of closure.
  • We intend to phase the withdrawal of day services so by Monday 23 March 2020, all day care opportunities will be suspended, apart from those for very high risk service users, whom we will support in our facilities.

East Lothian Integrated Rehabilitation Service (ELIRS)

  • All community Occupational Therapy and Physiotherapy patients have been priority-rated and non-urgent cases cancelled. 
  • Only urgent MSK patients will be seen in the MSK departments by a reduced staff. 
  • All other staff (including administrative posts) will be deployed to ward or community work.
  • We are providing appropriate training to support staff redeployed into community and ward areas. 
  • All staff are being directed to produce personal resilience plans and risk-assess where needed.

East Lothian Community Hospital (ELCH)

ELHSCP has been instructed to provide extra capacity for acute-sector patients.

  • 44 beds are being established in Ward 6.  Equipment is being sourced for these.
  • Belhaven Ward 3 and Edington will also be cleared to provide additional bed spaces.

NHS Lothian, at the instruction of the Scottish Government, are cancelling all non–urgent outpatients’ clinics. This applies to (non-cancer) endoscopy activity as well.

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