Coronavirus (COVID-19) Core Brief

Information for staff across health and social care (from Scottish Government – Health COVID-19 Communications Health COVID-19 Communications)

Information for staff across health and social care

Monday 23 March 2020

Latest News

Published test results today Monday 23 March show that a total of 9,264 Scottish tests have concluded. Of these 8,865 tests were confirmed negative with 499 tests positive. Fourteen people who had tested positive for coronavirus have sadly died.

Figures are updated and published at 2.00 pm every day on the Scottish Government Coronavirus (COVID-19) page at www.gov.scot/coronavirus-covid-19.

Social Care at Heart of Response to Coronavirus (COVID-19)

Councils have been asked to increase support for care at home, nursing homes and care homes to reduce delayed discharges and free up hospital beds. Cabinet Secretary for Health and Sport Jeanne Freeman has confirmed to COSLA that, subject to expenditure being aligned to local plans, the Scottish Government will meet additional costs to increase support and staff capacity in social care. The move aims to help the care system adapt to increased pressure placed on it by COVID -19, with many people requiring continued support for daily living, even if they have not contracted the virus.

Community Assessment Hubs

Patients with coronavirus (COVID-19) symptoms are now asked to dial NHS 24 on 111, day or night, if their symptoms worsen or do not improve after seven days. In addition, people are being asked not to call their GP or go to the surgery. If they require a sick note due to coronavirus, they will be able to get this from the NHS Inform website. This improvement provides patients with a straightforward dedicated route to clinical advice and support, as well as freeing up GP practices to treat and care for all non-COVID-19 health conditions.

Callers to the 111 helpline will be assessed and, if necessary, transferred to a local community hub staffed by clinicians from across the healthcare system to ensure patients get the best possible advice at the right time. Depending on their assessment, patients may be given advice to help them continue self-isolating at home or be given an appointment to attend a local assessment centre for further treatment.

NHS Inform’s coronavirus webpage is still the fastest way for people to get the latest health advice and information. There is also a free NHS 24 helpline for people without symptoms looking for general information on coronavirus. For patients who do not have any coronavirus symptoms, they should continue to telephone their GP when open and not call NHS 24. In the out of hours period, when displaying symptoms other than coronavirus, people should only call 111 if you need urgent assessment and cannot wait until your GP is open.


Enhanced Role for Community Pharmacists

Community pharmacists are to perform an enhanced role during the Coronavirus (COVID19) outbreak. Pharmacists will be able to support more patients, reducing the pressure on other parts of NHS Scotland through the extension of the Minor Ailment Service. The Scottish Government has also accelerated plans to expand access to Emergency Care Summary (ECS) data, which mainly contains medication information, to pharmacists.

NHS Boards have been asked to provide access to this information to pharmacists and pharmacy technicians working in communities. More than a thousand community pharmacies provide a range of NHS Pharmaceutical Care services on behalf of the NHS in Scotland.

Testing

Currently only high-risk (admitted) patients are being tested. This is partly because of laboratory capacity. Current capacity is limited, but it is our intention to increase this to 3,000 a day. This programme is being expanded to cover critical frontline NHS Scotland and social care staff, and workers in other critical areas. Guidance on this will be issued shortly. Surveillance testing is also being scaled up, which will give us a more accurate picture of how the infection is spreading in certain areas.

Protective Equipment

We recognise that staff across health and social care have concerns about the availability of Personal Protective Equipment (PPE) and are working to ensure staff have access to this where appropriate. NHS National Procurement is issuing a daily bulletin to NHS Boards and Local Authorities on supply issues.

Health Service Capacity

NHS Scotland is now on an emergency footing for at least the next three months. Our first goal is to double the Intensive Care Unit (ICU) capacity across Scotland. NHS Boards are working towards this by providing the necessary training for staff and by repurposing facilities.

Our contingency planning for the supply of oxygen both in hospital and in the community is in place. For example, we have ordered further new standard concentrators for use in the community, as well as further contingency to be called on if necessary.

Current bed capacity

NHS Boards are now taking all necessary steps to have available 3,000 free beds to cope with COVID-19. To achieve this, our normal programme of nonurgent elective operations has now been suspended and we are working to reduce delayed discharges by 400 by end March. This should free up certain staff for redeployment and guidance has been issued to NHS Boards on this

We are also looking at backfill posts, with a specific focus on encouraging and supporting retired staff to return to the workforce. Chief Nursing Officer Fiona McQueen has published Guidance on returning to registered professional practice to help with patient care in light of developments relating to coronavirus (COVID-19).


Social Care

Extensive work is already underway with our partners to put in place arrangements to increase social care workforce capacity. We have approved a range of immediate changes to the Scottish Social Services Council’s approach to workforce regulation, which will support social services providers in focusing on their response to the pandemic.

The Cabinet Secretary for Health and Sport wrote to the social care sector on 13 March with updated Health Protection Scotland guidance. The Chief Medical Officer has also developed targeted and clinical advice for nursing and residential care residents for Coronavirus (COVID-19). We are exploring the scope to use social workers and other health professionals employed by public bodies.

School Closures and Key Workers

Precise arrangements for the children of key workers will depend on decisions made by local authorities. However, Local Authorities should be putting in place provision to ensure children of key workers have continuing access to appropriate learning and childcare. Keyworkers have been defined as: 

  • Health and care workers
  • Energy suppliers
  • Staff providing childcare for other key workers
  • Fire, police and prison workers
  • Other workers without whom there could be a significant impact on Scotland.

While many people will believe they are a key worker – and many working across health and social care will be – if your staff can work from home then you should encourage them to do so.

Advice for Parents and Carers

Advice for parents and carers on managing the impact of Coronavirus (COVID-19) on their child’s learning and family life is now available. Following school closures, a new hub of information has been created on parentclub.scot covering health information, advice on how to talk about Coronavirus (COVID-19) and ideas on helping children through this time. In addition; councils and head teachers can also advise parents and carers on the continued provision of education and childcare for key workers.

Sources of Information

Information for the public on COVID-19, including stay at home advice for people who are self-isolating, can be found on NHS Inform at: https://www.nhsinform.scot/coronavirus

Health Protection Scotland guidance for healthcare workers and for non-healthcare settings is continually being updated and added to. This can be found on the Health Protection Scotland website.

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.

Arrangements for visiting care homes, resource centres, day centres and lunch clubs

Care homes in East Lothian

East Lothian Health and Social Care Partnership is implementing Scottish Government guidance for COVID-19/coronavirus and, from Thursday 19th March 2020, is restricting visiting times to residents at The Abbey, Crookston and Eskgreen Care Homes to Wednesdays and Sundays:

  • 2pm to 3pm
  • 7pm to 8pm.

We ask that only one person visits during these times, no one under the age of 12 years and if you have any underlying health conditions, are over 70 years old or feel unwell in any way, please do not visit. Families will be supported to access the homes at other times if residents needs’ change or circumstances change.

If your relative or friend is at a privately-operated care home or nursing home, please phone them direct to find out what restrictions they have in place.

Resource, Day Centres and Lunch Clubs

We need to follow public health guidance to ensure ‘social distancing’ for our most vulnerable service-users. East Lothian Health and Social Care Partnership has reached a decision to suspend the provision of community support and ‘day hospitals’ temporarily from 23 March 2020.  We have written out to services-users and carers to let them know.

This decision also reflects what is happening in other Lothian Health and Social Care partnerships.

We are making arrangements with day centre staff and others to monitor and support people who use our services to offset the effects of the closure of day services.

Arrangements will be made with the Resource Centre staff and others to provide support and to monitor clients to mitigate the effects of the closure of day services, ensuing priority clients have an individual support plan.

Services include:

  • Tynebank, Port Seton and Fisherrow Resource Centres
  • Day Centres
  • Lunch Clubs

We know that many individual day centres and lunch clubs are making arrangements with their service-users for support while the clubs are closed.  Please speak to your day centre or lunch club about their plans.

Our home meals delivery service continues to operate as normal.

IMPORTANT NOTICE REGARDING CHANGES TO GP APPOINTMENTS

Practices in East Lothian are following guidance shared by NHS Scotland and Public Health authorities to minimise risks associated with COVID-19/coronavirus

They are asking for your support to protect patients and staff.

Before you contact your practice, consider checking www.nhsinform.scot for advice about corona virus and any other health problems. 

Most patients with symptoms of corona virus will not need assessment and will be able to manage their symptoms at home, following the advice on NHS Inform website.

New appointments

  • Do not go to your practice unless you have been asked to do so by practice staff
  • Do telephone your practice to request an appointment, telling them about your medical need.
  • Expect to be asked questions about your symptoms before any appointment is arranged
  • You may be offered a consultation by phone
  • If you do need a face-to-face appointment, this will be arranged
  • If you need a corona virus assessment, they will ask you to self-isolate for 7 days

Existing appointments

  • Practice clinical teams are reviewing all pre-existing appointments
  • If they think your appointment is not urgent, they may reschedule it for a later date
  • If your appointment needs to go ahead, the practice will offer you a phone consultation, wherever possible
  • Your practice’s admin team will contact you if your appointment is cancelled or changed to a telephone appointment
  • If you need a face-to-face appointment, they will ask you some screening questions to make sure that it is appropriate for you to attend
  • Please try to order repeat prescriptions online.

Access to medical centres

You should only go to your medical practice if you have been invited to do so by a clinician at your practice.

  • People who have not been invited will be asked to leave
  • Only patients with appointments will be allowed into medical practices
  • If you are a parent/guardian/carer, you may be able to attend with the person you care for – please check
  • Remember to use the hand sanitiser provided when entering the building or wash your hands in the patient toilets.

Thank you. We appreciate your co-operation and support

NHS Inform is an excellent source of up to date information.