Dealing with our frustrations offline

I know we all have our frustrations to bear, but can I ask that if you have an issue with anything work-related, your deal with it offline and through the appropriate channels, for example, your line manager. Or you can always email me direct at myvoice@eastlothian.gov.uk

Please don’t try to resolve things on social media. We should always be respectful towards our partner organisations and remember that we are all in this together.

Nuff said.

Alison

Update on ELC Services including Children’s Hubs

Children’s Hubs

East Lothian Council is continuing to support our children and young people during the national closure of schools.

You will be aware that, in order to meet the emergency learning and childcare needs of key workers, we are operating six Children’s Hubs.

The Hubs will provide emergency childcare for children with at least one parent who is a key worker and who don’t otherwise have another adult at home to care for them.

Demand for places is vastly exceeding availability. In Phase 1 of this process, we have used information provided by parents/carers to identify those who are key workers in accordance with definitions provided by the Scottish Government, with a particular focus on ‘Category 1’ workers.

Parents in this category who have been allocated places for their children were being notified individually of the arrangements being made for their children by 24 March 2020). It is anticipated that places for these identified children will begin on Wednesday, 25 March 2020.

We are also reviewing the requirements of vulnerable children and children with additional support needs.

Next, we will move to Phase 2 of allocating places where, if available in the Hubs, we may be able to allocate places to some parents who fall into other employment categories. If successful, these parents will be notified by East Lothian Council that a place can be provided in a Children’s Hub for their child by Friday, 27 March. These Phase 2 places will start on Monday, 30 March 2020.

We will notify parents if we are unable to provide childcare places in the week beginning Monday, 30 March 2020. It is essential that parents notify us if they no longer require a place.

Each Hub will be overseen by a leadership team including a Head Teacher, supported by teaching, other specialist and support staff. At the early stages, Hubs will be open from 9am until 3pm with extended day provision being planned from next week.  We will also provide food for our children in the Hubs.

Free school meals

At this stage, free school meals for those eligible can be collected from one of the Children’s Hubs mentioned above. As we are seeking to make this as easy as possible – particularly for those living in outlying communities – we will be reviewing this process ahead of next week.

Remote learning

We are maximising the use of digital technology to support learning for children who are being cared for at home. This includes use of online tools which children and teachers can use to provide learning for children at home through Google G-Suite. Teachers are posting learning assignment tasks for children, including active learning opportunities which they can undertake with their families.

We hope there will also be opportunities to participate in live lessons and we are working to support staff on this. These tools can be accessed through tablets, smartphones and home computers. We have provided Chromebooks for children without access to such devices at home.

Connected Communities Bases

We are planning to run bases which will be used to support local community resilience arrangements to help the most vulnerable people living in East Lothian’s communities. Across the county, volunteers within our communities are already providing a significant amount of help and support for neighbours and fellow residents. The bases will provide resources that they can draw upon. Resilience groups will be contacted directly with details on how they can use these bases. Further information will be provided shortly.

Volunteer register

A new volunteer registration service is being established to connect well and willing volunteers with their local resilience group efforts.

The volunteer registration service will help people in communities who are not already connected to a community group/organisation, to provide details of their willingness to participate in volunteering country-wide.  Again, more details will be provided in due course.

Customer Access Points

For essential customer enquiries only, Customer Access Points will be operating at the following locations:

  • Brunton Hall, Musselburgh – 10am to 12 noon and 2pm to 4pm (Monday to Friday)
  • John Muir House, Haddington – 10am to 12 noon and 2pm to 4pm (Monday to Friday)

In the interests of everyone’s wellbeing, visitors will be asked to ‘self screen’ on arrival and maintain social distance.

Public toilets

All of our public toilets have been closed. Available staff are being redeployed to support building deep cleans. This approach will enable deep cleaning to be carried out at regular intervals.

Changes to waste and recycling services

From today (Wednesday, 25 March) collection of both the green and blue recycling boxes will resume across East Lothian, on normal calendar dates. We are also continuing to collect non recyclable waste fortnightly, as per calendars. Brown bins for garden waste collections remain suspended until further notice.

If this situation changes due to staff shortages during the current Coronavirus crisis, we will issue further updates via our website and social media. As of yesterday (Tuesday 24) all four of our Recycling Centres are closed until further notice.

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

Wednesday 25 March 2020

Latest News

Published test results yesterday Tuesday 24 March showed that a total of 9,968 Scottish tests had been concluded. Of these 9,384 tests were confirmed negative with 584 tests positive.

Latest figures today 25 March show that 22 patients who tested positive have now died. The Scottish Government is working hard to update the latest figures for test results. These will be available later on the Scottish Government Coronavirus (COVID-19) page at www.gov.scot/coronavirus-covid-19.

New Social Distancing Measures

The First Minister has called for an immediate stop to public gatherings of more than two people in Scotland in a bid to flatten the curve of Coronavirus (COVID-19) spread and to protect the NHS. Following a meeting of the UK Government’s COBR committee, an effective ban is in place on gatherings in public places, excluding household groups or in a work-related capacity.

In addition – as the First Minister had set out previously – all non-essential shops should be closed, as well as public spaces such as libraries, communal parks and playgrounds, and places of worship. The ban extends to ceremonial social events, such as weddings and christenings, with the exception of funerals which will be restricted to immediate family only. The First Minister was clear that these decisions are not taken lightly, ‘but are essential for the protection of all of us.’ From last night, the only permissible reasons to leave your home are as follows:

  • to shop for basic necessities and that should be limited to once a day
  • to take exercise once a day – but alone or with your own household, not in groups
  • for medical reasons or to care for an ‘at risk’ person
  • to travel to essential work if that cannot be done at home. Further guidance to employers will be provided shortly.

In agreement with Police Scotland, officers will be permitted to deploy ‘soft enforcement’ of these measures, prior to the Scottish Government taking legal powers from Thursday. The First Minister reiterated guidance for people to stay home and only venture outside when absolutely necessary. In line with existing advice, non-essential retail units are now required to close and shopping for basic necessities kept to a minimum.

At Risk Groups

Around 200,000 people who have specific forms of cancer, severe respiratory conditions, rare diseases, have received organ transplants, are on immunosuppression therapies or who are pregnant and have congenital heart disease are being asked to self-isolate within their homes. These people are at particularly high risk from Coronavirus (COVID-19) and this measure is intended to safeguard them and their families. People in these groups will be contacted in the next few days to explain what they and their families are being asked to do. They will also be provided with information on how to keep themselves safe as well as providing support for healthcare, access to medicines, services, food and supplies.

Other People at Risk

While the focus, for clinical reasons, has been on the high risk groups, broader support will be needed for other groups who have long-term clinical conditions and others who are at risk for reasons of finance, living circumstances or social factors. Many more people may need assistance and work will be taken forward with resilience partners in the coming days. This will include others in society that require special support in the current situation, including: homeless people; rough sleepers; asylum seekers and refugees; and others. Support will be provided to frontline homelessness services to help them support rough sleepers and people in emergency accommodation to self-isolate.

Problem Alcohol/Drug use

The Scottish Drugs Forum has developed national guidance on business continuity for the delivery of drug services. This was issued on 19 March. Further guidance is being developed by Scottish Health Action on Alcohol Problems on continuity for people with alcohol problems, which will be issued in the coming days.

Testing

The Cabinet Secretary has announced that prioritised testing for coronavirus (COVID-19) will allow key health and social care workers to return to work. The Scottish Government has published guidance for NHS Scotland to prioritise testing to enable health and social care staff to get back to work, based on the pressures local boards are facing. As testing capacity increases, this will be extended to other key workers.

Access to Protective Equipment

The Scottish Government and NHS Scotland is working hard to quantify Personal Protective Equipment (PPE) requirements across the system with a particular focus on the Scottish Ambulance Service and social care. All NHS Boards have received supplies of appropriate protective equipment, including facemasks, aprons, gloves and goggles, to distribute to GP practices as a precautionary measure. NHS National Services are keeping the position with supplies under constant review and work is ongoing to ensure stocks are maintained in order to continue to protect those who may need it.

Mental Health

It is important that people with mental health problems get the right help, at the right time, and in the right place. Throughout this time, some people may be anxious or experience
emotional distress. The Scottish Government and NHS Scotland are working with our partners, including NHS 24 through NHS inform, to provide good quality, up-to-date and trusted guidance for people who need to self-isolate. Isolation and distancing will have an impact on the mental well-being of the population and so mental health support is being developed to help individuals maintain good mental health. It is also recognised that there are specific groups who are more at risk as a result of Coronavirus (COVID-19) and work is being undertaken with our partners to ensure they are cared for and supported. Enhancing the support available will be key and we are building on existing services such as the ‘Breathing Space’ helpline to ensure people are getting the help they need, when they need it.

Health and Social Care Workforce

Staff across health and social care continue to work incredibly hard at this time of unprecedented challenge. Their hard work, commitment and professionalism is to be admired and there is no doubt that they deserve our thanks. But staff also need to look after themselves. Our NHS Scotland and social care staff are being asked to work in unfamiliar settings. Many will be asked to learn new skills and to work in new roles. Many may be personally impacted by the virus and some will be caring for their own families. This is no small ask. Staff are being urged to take care of their basic needs – eat and drink regularly and healthily. Allow time for sleep, rest and respite between shifts. Engage in physical activity and always take regular breaks during shifts.

Community Pathway Hubs

Monday’s Core Brief provided information on the setting up and resourcing of community assessment hubs. From 8.00 am on Monday, all NHS Boards had set up and resourced Community Hubs, with NHS Highland covering the three island NHS Boards. NHS 24 has made the necessary adjustments to its systems to connect with Community Hubs. The aim of the new hubs is to:

  • help people get advice quickly, and be managed safely (where it is appropriate to do so) in their local community
  • take triaging burden from General Practice and reduce the risk of individuals with symptoms visiting their GP practice
  • better manage demand and capacity through a whole-system approach.

Pregnant Women

Whilst current evidence does not seem to suggest that pregnant women are more susceptible to this virus than the general population, we do know that, in general, pregnant women are more susceptible to infection and therefore, as a precaution, pregnant women have been advised to take particular care to minimise their social contact. All pregnant women will continue to receive maternity care throughout their pregnancy but care may be offered in alternative sites or using phone or telehealth consulting where appropriate and to reduce the chance of infection.

The Royal College of Obstetricians and Gynaecologists (RCOG) has produced updated COVID-19 advice for pregnant women that pregnant women up to 28 weeks gestation, including healthcare workers, can continue working. This can be found at: https://www.rcog.org.uk/coronavirus-pregnancy

Health Service Capacity

Delayed Discharge

We continue to work with health and social care partnerships to drive reductions in delayed discharges. The latest daily reporting shows a reduction of 257 delays since 4 March, representing good progress.

Staff Who Have Left the Service

Staff who have left their professional register within the last three years as a Registered Nurse, Midwife, paramedic, physiotherapist, occupational therapist, diagnostic or therapeutic radiographer, or as a biomedical scientist, are being urged to consider returning to work in NHS Scotland as a registered practitioner, on either a full-time or part-time basis, now or at any point over the coming months. Any contribution returning practitioners can make will be very welcome.

Students

The Government is also working closely with Higher Education Institutions, NHS Boards and others to consider what role students might be able to play. Plans for students will be set out in the coming days with an assurance that there will be no detriment to students’ positions.

Recent News Releases

All news releases can be found on the Scottish Government website at: www.gov.scot/news.

COVID-19 testing to get key workers back to work Enhanced role for community pharmacists Planning for Brexit Increased support for social care Support for business water bills New NHS 24 arrangements.

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.

Resources

The public Communications Toolkit, resources and digital assets are continually being updated as the situation changes. These can be found on the NHS inform website. Please keep revisiting the site for the latest assets.

Staying Safe & Well: Self Care Guides for Staff looking after patients with Coronavirus

Psychology have put together this info for staff

We know from recent public statements that the pandemic is likely be disruptive to our own lives, the way we provide care and may be a cause of natural anxiety.

A spotlight is shining on the important work we do every day to care for our fellow citizens when they are very unwell. Amid the anxiety about the impact of the pandemic, there is a fresh appreciation and gratitude for our labour and a desire to support you as best we can as you look after people with coronavirus.

Here are the guides:

Thank you for everything you’re doing for all of us.

Restrictions to hospital visiting – essential visits only now

In the light of the updated advice around reducing the risk of spreading Covid-19 and shielding vulnerable groups, NHS Boards are now being asked to restrict hospital visiting to essential visits only with immediate effect.

The following visits are deemed essential: 

  • A birth partner during childbirth 
  • A person receiving end-of-life care 
  • To support someone with a mental health issue such as dementia, a learning disability or autism where not being present would cause the patient to be distressed 
  • To accompany a child in hospital.

Visitors should also consider whether a visit is essential even in these circumstances.

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.