Agenda item

Jacqui Scott, Chief Executive Officer – Bromley Healthcare (“Chief Executive Officer”) provided an update on the COVID-19 response by Bromley Healthcare.

The Chief Executive Officer noted that she was lucky to have a fantastic team who, overnight, had risen to the challenge of providing care that they never would have expected. Around 30% of the organisation had been repurposed, with non-essential parts of the service being paused. The skills of these staff members had been looked at, to ensure best fit into a COVID-19 team, and some Care Co-ordination Centre staff had even trained as Health Care Assistants and phlebotomists. The finance team had manned the PPE stock room, and HR staff had been answering calls to the hotline. Executive staff had also been involved, undertaking swabbing and antibody testing. The feedback received from this had been extremely positive, and the cross training had allowed a greater understanding of what other team did – some staff members did not want to return to their roles and would instead retrain in the nursing arena.

The Bromley Community COVID Monitoring Service had been set up in two days and had been established in collaboration with the SEL CCG and GPA. This repurposed community matrons, respiratory nurses, consultant paediatricians and local GPs, who accepted referrals for patients with suspected COVID-19 from the 111 service. They responded within two hours to provide support and daily calls were made to the patient. At the peak of the pandemic, this team was undertaking 100 daily calls, and overall had received 3,000 referrals. The team had also recorded all the clinical information on a daily dashboard, to display what was happening within the service. This provided a safety net, to ensure that patients received their daily calls. Over the last few weeks, the Community Matrons had contacted around 10% of patients that gone through this service to gain feedback – 95% had said they had felt supported, and some lovely comments had been received.

At the beginning of the pandemic, the main concern had been to ensure that all vulnerable patients were able to be seen. There was an increase in hospital discharges, plus a number of new team members, with a range of competencies, following their redeployment into other teams. It was therefore thought to be safer to bring forward the roll out of the Malinko Auto Scheduling Tool. This system allowed the competencies of staff to be matched with the intervention required to be undertaken. It also minimised travel time and ensured that visits happened at the right time. Nurses had been provided with laptops to view GP records during visits, and smartphones to inform patients if they were running late. The aspiration was that by the end of the financial year, patients would be provided with time slots for appointments.

The Single Point of Access (SPA) for discharge had been established with the SEL CCG and Local Authority and was run by repurposed nurses and therapists who looked after patients on a number of different discharge pathways. There was a single phone number for the hospital to call if they wanted to discharge a patient from any of their wards, and they would speak with a clinician regarding the best wrap around care. 800 discharges had been made via this service, and since the end of March 2020 there had been a reduction in the length of stay in hospital beds. It was noted that many within the Bromley Healthcare team did not feel as though they were moving into recovery as they were busier than usual with 75,000 face to face and home visits, and over 30,000 virtual appointments, being carried out. Each team lead had been using the Zoom virtual meeting platform to meet with as many of their team members as possible to reflect on the COVID-19 response. Teams had also been asked to draw up their restart and escalation plans.

The Chief Executive Officer noted that one positive to come out of the pandemic was that Bromley Healthcare had moved their transformation programme forward from twelve to three months. It was emphasised that the 0-19 service was still on track and would be mobilised from 1^st October 2020.

In response to a question from a Member, the Chief Executive Officer said that Bromley Healthcare did everything it could to retain its student nurses. In March 2020, 14 nurses had joined, inductions had taken place, and they were working within the Bromley Healthcare teams. Twice a year, newly qualified Band 5 nurses undertook a 12-week face to face readiness programme to build competencies. This was an attraction, and through word of mouth there was more and more interest in this scheme.

A Member expressed his thanks and admiration to the Bromley Healthcare staff. It was noted that an extremely impressive report had been provided to the Sub-Committee, which highlighted the excellent work they had undertaken. In response to a question regarding how Bromley Healthcare staff had worked with Local Authority social workers, the Chief Executive Officer said that the SPA was a good example of this. As patients were discharged from hospital through the SPA, they were given a care package and Bromley Healthcare therapists visited to undertake welfare checks. From this work, 30% of the checks highlighted a need for a change to the equipment provided, which the therapists were able to do.

A Co-opted Member noted that part of the information relating to the Bromley Community COVID Monitoring Service mentioned anxious patients being referred to Bromley Talk Together, and asked how long patients had to wait to access this support; the nature of the support; and how long the support had lasted. The Chief Executive Officer advised that patients calling the monitoring service were often very anxious. Their details had quickly been passed on to the Bromley Talk Together service, for which there was no waiting list for support. A staff line was also providing support. Around 10,000 consultations had been undertaken – 30% had been via Zoom, and 70% via telephone or other means. Recovery rates from the service were very good and had been at around 60% during the pandemic.

The Chairman led Members in thanking Jacqui Scott for her update regarding the work of Bromley Healthcare, and reinforced the Sub-Committee’s appreciation for the work undertaken.