The NHS and social care system in north Cumbria and beyond is dealing with its biggest challenge yet, with a big dose of determination, tenacity and innovative ways of working to provide the best care possible to the community.
The COVID infection rate in the community is now at record levels, particularly in Carlisle where the rate is over 1000 per 100,000 and in Eden where the rate is more than 700 per 100,000. This has inevitably led to more hospitalisations with hospitals in North Cumbria now caring for more patients with COVID than in the first peak, and services are preparing for a tough few weeks ahead.
The health and care services have implemented business continuity plans to ensure it can continue to care for those who need it most. For example:
- Social care partners are supporting care homes and ensuring that people can return home as soon as possible when they are ready to be discharged from hospital.
- Primary care services are putting plans in place to deliver the largest vaccination programme in history, alongside delivering their routine services for patients.
- Hospital and community services are continuing to provide care for those with the most urgent needs
Dr Jon Sturman, is the Clinical Director for Intensive Care at North Cumbria Integrated Care NHS Foundation Trust. He said:
“Within the hospitals we are caring for patients in excess of the numbers we have seen previously, even in the first wave. This means that we have to respond by continually changing the number and type of beds we have available for people who are COVID positive and ensure strict infection prevention measures are in place.
“We are providing additional intensive care capacity on site through our business continuity plans and are able to access intensive care through the critical support network across the region. This has had an impact on some of our routine services however we are doing everything we can to ensure we maintain urgent and emergency treatments.”
Anna Stabler, Chief Nurse at North Cumbria Integrated Care NHS Foundation Trust said:
“The efforts of our staff has been phenomenal. There has been no hesitation from staff stepping in to support in areas unfamiliar to them or working over and above their normal duties. Many of our staff members have been redeployed into different roles as they were in the first wave, for example theatre staff delivering intensive care support, and now we also have staff redeployed into roles such as delivering the COVID vaccine to health and care workers, and people over 80.
“Many of these duties may not be as visible as others but examples have included operational managers working on our wards to support patient discharge and providing direct support to front line teams. Our Chaplaincy team have also provided a listening ear to support both our staff and patients, and our volunteers are taking on additional roles in supporting patients and staff.
“Staffing has been a challenge - our staff members are also part of the community and some have been required to self-isolate, which has brought additional challenges right through the Christmas holidays. Staff have responded by working extended hours, additional shifts and have postponed planned annual leave to care for people in our communities. This has included Midwives, Health Care Practitioners, Doctors, Nurses, operational management teams and support staff across all our acute and community hospitals as well as our community staff who have also supported in local residential and nursing homes.
“It really has been a monumental effort, and it continues to be challenging and exhausting for all of our staff across the system, and we do have support mechanisms which we are stepping up at this time.”
In primary care, GPs are prioritising the delivery of the COVID vaccination alongside business as usual. Distington GP Dr Helen Horton said:
“There are huge efforts in primary care to get the vaccine programme underway, it has taken a lot of planning. Feedback from patients, our staff and the volunteers supporting us, has been really positive, our over 80s are really excited about getting the vaccine and the protection it offers.
“We are looking forward to the rollout of the Oxford Astra Zeneca vaccine which will make it much easier for us to get to patients who are housebound and into our care homes. We please urge the public not to call GP surgeries
“GPs are also still seeing all of our patients who need medical help – other problems and concerns haven’t gone away and we are still looking after those who need us. Please bear with us. It is incredibly busy and we are grateful for people’s patience.
“We know people are keen to get the vaccine but please don’t call us, when it is your turn you will be contacted by the NHS.”
Anna Stabler added:
“We know that we already have fantastic support from our communities. We also know, that we have a very difficult few weeks ahead of us, so we now more than ever, we are appealing for the following:
- Stay at home, protect the NHS and save lives. Please reduce your chances of being affected by or transmitting coronavirus unknowingly by ensuring you follow the guidance of staying at home and only leaving your home for the reasons set out in the government guidance.
- Choose our services wisely – if you have been invited for an appointment, please attend. The NHS is still here for you, but please choose the service most appropriate for their need when they need to access medical help. This includes:
- Partner/one person from social bubble can accompany for all scans
- 111 – this service provides 24 hour advice on any healthcare need
- Pharmacy – think pharmacy first where there are trained professionals who can prescribe medicines and give advice
- GP – for ongoing or persistent medical issues
- Minor injuries and Urgent Treatment centres – for urgent but not life-threatening issues
- A&E - for life-threatening and serious emergencies only.”
- Maternity guidance - If you have any worries regarding your maternity care, your points of contact have not changed. Your midwife is here for you and will be able to discuss your queries. Current guidance includes:
- Partner/one person from social bubble can accompany for all scans
- Antenatal appointment – Mother should attend alone where possible
- The birthing partner is able to attend with their partner for labour assessment and throughout labour. Following delivery, whilst the mother remains on delivery suite, the partner can stay. When she is transferred to the postnatal ward, the partner will be asked to leave.
- Each mother is allocated visiting time slots both AM and PM to enable their partner to visit, whilst respecting social distancing and ensuring correct use of PPE.
- The partner can then return to take the woman and baby home on discharge.