2 April 2020

Innovation and change to manage Covid-19 at ESHT

East Sussex Healthcare NHS Trust is putting in place a number of changes to manage the increase in patients with suspected or confirmed Covid-19.

The Trust is temporarily modifying a number of services to significantly increase critical care capacity for those patients who are suspected or confirmed as having Covid-19. These changes will allow Covid-19 suspected or positive patients to be treated in safe environments away from other patients and where staff can be protected. At the same time we are working to provide routine emergency and urgent care in the safest and most effective way that protects our most vulnerable patients.

Adrian Bull, Chief Executive said: “It is a worrying time for patients, our local communities and members of staff. Life has changed radically for all of us but I want to reassure local people that our plans mean that we are ready to provide health care for the people of East Sussex. Across the organisation we have made a significant number of changes as we gear ourselves up to manage the Covid-19 pandemic here in East Sussex.

“The levels of innovation and change we have seen over the last two weeks are astounding. In many areas we have made 12 months’ progress in 12 days. Members of staff are adapting to constant change and challenging many commonly held assumptions. I see colleagues across the organisation working hard to make sure we continue to provide the best care possible for our patients in new and different ways.

“It is important for everyone to help us and play their part in reducing the spread of this virus. Please follow the government’s advice to regularly wash your hands and stay at home. Only go out if essential and when you are out, maintain social distancing.”

Changes made in response to Covid19 include:

Critical Care Capacity increase: We have already doubled our normal critical care capacity, and our aim is to ultimately have five times our normal capacity. This involves expanding critical care into theatres and recovery areas.

Relocate Chemotherapy Services: To minimise the risks to our cancer patients, we have temporarily moved chemotherapy and infusion care to East Sussex College in Eastbourne. This change in location means that we can safely deliver treatment to cancer patients away from the main hospital.

Created discharge hubs: Our new seven-day Discharge Hubs are supporting the rapid discharge of patients as soon as it is clinically safe to do so. Working with local partners we have significantly reduced the numbers of medically fit for discharge patients in our hospitals.

Maternity relocation: We have temporarily suspended the homebirth service and Eastbourne Midwifery Unit (EMU) service. All deliveries will be in the Obstetric Unit at Conquest Hospital, Hastings. A key factor in making this decision is that the ambulance service is under considerable pressure, and could not guarantee a timely response to calls in an emergency. This presented an unacceptable risk to mothers and their babies. The obstetric unit at Conquest has a dedicated entrance door so that there is no need for mothers to go through the hospital.

Cancelled non-urgent operations and procedures: We have cancelled all non-urgent operations and procedures to free up clinical areas and clinicians to help treat Covid-19 patients. We understand the frustration this will cause many people and their procedure will be rebooked at a later date. We will continue to perform urgent and emergency procedures with some taking place in other facilities away from the main hospitals. Cancer treatment continues with close attention being paid to referral and treatment volumes to make sure that cancer cases continue to be identified, diagnosed and treated in a timely manner.

Increase in telephone outpatients appointments: Some appointments have moved to a telephone conversation with the hope that we will soon be able to offer some video appointments in the future.

Visiting restrictions: To help us keep our patients, staff and visitors safe, stop the spread Covid-19 and keep our hospitals running, we have had to put strict restrictions on visitors.  Please see visiting restrictions

Speeding up recruitment processes: The recruitment process for new employees is being fast tracked to allow more clinical staff to start working on the wards sooner than would normally be the case. We are also contacting all members of staff with lapsed or current healthcare registration who do not currently work in clinical roles and are offering training so that they can support frontline care.

Staff training: Additional training is being provided to a wide range of clinical staff such as HCAs, staff nurses, matrons, junior doctors of all grades and senior clinicians. For example, intensive Care consultants are providing training for members of clinical staff who might be required to support patients requiring ventilation. 

Temporarily move of emergency cardiology: The Cardiac Catheter Service has been temporarily moved to Eastbourne DGH.  The out-of-hours emergency cardiology has for a number of years been provided at Eastbourne DGH one week and Conquest the next. This means we already have tried and tested transfer procedures to move emergency patients across the county, depending on the week.

We anticipate 10-12 patients per week requiring emergency cardiology will be transferred to Eastbourne from the Hastings catchment area.

Ophthalmology: To minimise the risks to our patients requiring sight saving eye procedures Ophthalmology outpatient clinics have moved to Bexhill Hospital. The clinics are for patients that have conditions that are imminently sight or life threatening that require to be seen urgently such as Acute Glaucoma and Wet active age-related macular degeneration.

No phlebotomy service at Bexhill Hospital: Bexhill Patients requiring phlebotomy that cannot be bled at their local surgery should book an appointment at either the Conquest or Eastbourne DGH. Patients will be given a number to ring to book an appointment for a blood test by their GP practice.

Distribution of donations: We are currently experiencing high volumes of offers of support from local and national businesses. We are extremely grateful for the support of our local community. A collection hub has been set up on each acute site to coordinate requests and support the distribution of donations. Please email  jacquie.fuller1@nhs.net with donation requests.

Volunteers:  We appreciate the significant numbers of people who have offered to volunteer to help us. It is important that we find suitable roles that are safe and most helpful. Please bear with us while we work to make the appropriate arrangements.