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Helping the people of Leicester to have long and healthy lives.

Leicester City Clinical Commissioning Group

How we are preparing

Find out how local health organisations are preparing for coronavirus and responding to the pandemic.

The local NHS and its partners are continuing to prepare for and respond to the Coronavirus situation. We are doing this through the Local Resilience Forum (LRF) for Leicester, Leicestershire and Rutland. The LRF is the multi-agency partnership made up of representatives from local public services including the emergency services, local authorities, the NHS and others. We are working together to implement the well rehearsed plans already in place to deal with a pandemic.

On 24th March the Police declared Covid – 19 a major incident and have now taken the leadership for strategic planning and response to the incident.

However, we are not underestimating the scale of the challenge. In the coming days and weeks we know we will continue to see a significant growth in the number of patients suffering from the disease, including those who are critically unwell. Sadly, it also inevitable that we will see an increase in the number of deaths reported locally, although we will do everything we can to minimise this number.

Click to find out more about the ways we are preparing

University Hospitals of Leicester NHS Trust (UHL)

Work has been prioritised to free up as much bed capacity as possible within Leicester’s hospitals. Tremendous work over the last few weeks with partners in health and social care has helped transfer patients that are medically fit for discharge and significantly increased the available bed capacity. We have also begun the process of cancelling elective (non-urgent) surgery for at least the next three months and have been reconfiguring wards and other clinical spaces to ensure that the hospitals can be used as flexibly as possible.

We are continuing preparations for the expected surge in demand during the coming weeks. Critical care beds are increasing from 50 to 150, with the potential for significant further increases depending on equipment availability. Clinical staff are having intensive refresher training to enable them to look after the numbers of patients requiring respiratory support and we have received nearly 500 expressions of interest from retirees and leavers who want to come back to help their colleagues. This is a phenomenal response.

At the same time, we have seen the numbers of patients attending or referred to the Emergency Department (A&E) more than halve in the last 4 weeks, (4,700 attendances in February down to 2,200 in March). Thank you to everyone in our local communities for exercising discretion over how they use NHS services.

To protect staff, patients and visitors the Trust has introduced strict visiting restrictions for the hospitals. From the 24th March UHL are not allowing visitors.

There will be exceptions made for people in the following circumstances:

  • Birthing partners
  • Parents of patients under 18 years of age
  • Immediate family/partners of those at end of life
  • Relatives collecting patients being discharged
  • Immediate carers for patients requiring assistance.

People who believe they fall within these criteria are being asked to pre-arrange their visits with the nurse in charge. The Trust recognises that these measures will be very difficult for families, but this decision is necessary for everyone’s safety in light of the situation we face.

For the latest guidance, visit: https://www.leicestershospitals.nhs.uk/aboutus/our-news/coronavirus/.

Temporary changes to Adult’s and Children’s Emergency Departments

To help keep people safe when they need emergency care as well as managing the increase in patients we expect to see, UHL has made some temporary changes to the way patients are seen at the Adult’s and Children’s Emergency Departments. The departments are now split into two separate areas: The Blue Department – for patients without symptoms of COVID-19 and The Red Department – for patients with symptoms of COVID-19.

Research

As a university teaching hospital with a flagship Biomedical Research Centre it is vital we play our part in understanding COVID-19 and other similar viruses and as such we are pleased to have recruited our first patients to an infection study which will contribute to national and international understanding of the pandemic.

If you would like to know more about the response of UHL to coronavirus please visit https://www.leicestershospitals.nhs.uk/aboutus/departments-services/emergency-department/

Leicestershire Partnership NHS Trust (LPT)

Leicestershire Partnership NHS Trust (LPT), alongside the wider NHS, has established major incident procedures to best coordinate its response to issues relating to the COVID-19 pandemic. We are responding to the incident in various ways:

  • setting up new services and wards to best meet expected surges in demand
  • altering the way we deliver services to minimise face-to-face contact and group based activities
  • adjusting our approach to patient contact in line with guidance on isolation and protective approaches
  • temporarily closing some services to prioritise delivery of critical services

We have been reviewing and adjusting our approach to services in line with the national guidance, and the latest position for each service is being described on our website (For latest information visit: https://www.leicspart.nhs.uk/).

This is focused on maintaining the delivery of critical services, and enables the Trust to safely staff and rapidly implement additional surge plans in critical service areas, in order to respond to expected increased demand. This has included preparing extra capacity, recruiting new staff and volunteers, and redeploying existing staff. We are creating extra capacity to deal with patients who have or who are strongly suspected of having the virus, and who are in need of hospital care.

Our ‘surge’ plans include expanding capacity in the following critical service areas:

  • An increase of around 70% in beds in community hospital inpatients (medical step down and end of life care) through a phased introduction of 75 Independent sector beds and an extra 72 beds on LPT additional community hospital wards.
  • Home First, community based end of life care and University Hospitals of Leicester (UHL) discharge hub: most LPT staff not redeployed to support an increase in bed numbers will be deployed to one of eight community hubs across Leicester, Leicestershire and Rutland, and to the discharge hub in UHL to support the delivery of anticipated increases in demand for these services.
  • A new Mental Health Urgent Care Unit at the Bradgate Mental Health Unit will open this week which will streamline urgent mental health patients to reduce the need to attend the Emergency Department at Leicester Royal Infirmary.
  • A new Central Access Point for mental health to provide direct number 24/7 to referrers and service users for mental health support started this week (6 April 2020).

Community hospitals

Preparations are at an advanced stage for creating extra capacity in Leicestershire Partnership Trust’s community hospitals to deal with patients as a result of the pandemic.

By the end of this week the Trust will have received 100 new beds, 100 mattresses, 100 bedside cabinets, 430 non-contact infrared thermometers, and 50 oxygen concentrators. These will be distributed to previously moth-balled wards at Loughborough, Coalville and the Evington Centre (City).

Coronavirus positive patients are already being treated at Hinckley and Bosworth Community Hospital and at Melton Mowbray Hospital.

To find out more about preparations at Loughborough Hospital, take a look at this shortfilm: https://youtu.be/wBN793pGa3Q

General practice

GPs across Leicester, Leicestershire and Rutland are using telephone and internet consultations wherever possible to see as many patients as possible without putting them at risk of spreading Coronavirus.

Routine face-to-face appointments have now been cancelled for most patients, except the most vulnerable or urgent cases after being triaged by GPs. Face-to-face provision is being consolidated where practicable in to ‘red zones’ for those patients displaying possible COVID-19 symptoms, helping to maximise the use of scarce human resources and equipment.

All patients should call their GP practice in the first instance.

NHS 111

The NHS 111 service is experiencing unprecedented levels of demand. Extra capacity is being provided, but it is important that patients concerned about symptoms use the online 111 coronavirus service if they possibly can.

Additional private sector capacity

Announcements were made over the weekend of a national NHS deal to acquire 8,000 extra beds, 1,200 extra ventilators and almost 20,000 fully qualified staff from the private sector. We welcome this extra capacity and are currently working with local private providers to understand what this may look like, and how it will work, locally.

PPE

The safety and wellbeing of staff and our patients is the top priority and you may be aware of concerns raised about the availability Personal Protective Equipment, (PPE), Nationally there is a huge effort to distribute supplies of PPE to NHS organisations locally.

You may also be aware of concerns raised about the correct use and type of PPE for different clinical settings. On 3rd April 2020, the Government and NHS leaders from a range of medical and nursing royal colleges have published new guidance about personal protective equipment (PPE) for NHS teams who are likely to come into contact with patients with coronavirus. The guidance is based on the best scientific evidence and the World Health Organization (WHO) have confirmed it is consistent with what it recommends in circumstances and settings with the highest risk of transmission. For further information visit: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control

New national guidance on admission and care of people in care homes has been published by PHE. It is for care homes, local health protection teams, local authorities, clinical commissioning groups (CCGs) and registered providers of accommodation for people who need personal or nursing care. It sets out how to admit and care for residents safely and how to protect care home staff. This will be used to support the development of local guidance.

The Lord Lieutenant is teaming up with local councils and business leaders in a new drive urging companies to donate personal protective equipment (PPE) for key workers. The appeal – spearheaded by Mike Kapur – asks firms to donate any new and unused items such as fluid-resistant surgical masks, nitrile gloves, goggles, disposable aprons or overalls, sanitising gel and overshoes, and to consider using their factories or equipment to produce more of these specific PPE items. You can read more here.

Staff testing for Covid-19

NHS England and Improvement (NHSE/I) has written to all NHS Trusts to ensure that we maximise available capacity for staff testing. There had previously been a 15% cap on laboratory activity directed to staff testing but this has now been lifted.

Testing is being focussed on hospital staff involved in critical care, emergency departments and ambulance services. Testing will now be extended to primary care, community staff and care home staff.

Keeping people informed

We are continuing to reinforce the messages on staying at home through our social media and other communications channels and ensure that the public is aware of the official sources of information and advice on staying well and looking out for the symptoms of Coronavirus.
New information is continually being made available and you may find this latest information from the Cabinet Office helpful.

  • The Cabinet Office has published Coronavirus outbreak FAQs: what you can and can’t do. This includes answers to questions such as “can I drive to green spaces?” and “can I go to the park?”
  • Guidance for the public on mental health and wellbeing
  • Keeping away from other people – new rules from 23rd March
  • Advice about staying at home

We are being made aware of misinformation circulating on social media so any help you can give to promote the official sources of information through your networks is appreciated.

We have been contacted by several people about the availability of information in other languages and formats. There is now a range of information available from Public Health England to meet different needs and languages. Please visit the PHE website for more details https://campaignresources.phe.gov.uk/resources/campaigns

We will also be launching a series of messages with partner agencies including the police and local authorities through an initiative with community radio stations. We are very grateful to the radio stations for providing us with free airtime to promote our messages. This will further help us to reach groups in the community through targeted community stations.

The NHS, local councils, police and other bodies have jointly worked on a new local information hub for Coronavirus. The website guides the public to the official sources of information, help and advice in Leicester, Leicestershire and Rutland. To visit the site go to: https://www.llrprepared.org.uk/one-prepared/

One Prepared is particularly helpful for those people who are considered as the most vulnerable and in need of support, for example with food deliveries and delivery of medication. It will help people to connect with the support available in their community.

Looking after NHS colleagues

We are of course aware of the need to look after the welfare of our teams during the Covid -19 outbreak. Ensuring their wellbeing is essential and working with other agencies in LLR we are promoting and putting in place measures to provide them with information and support.