Health and care staff across Surrey are continuing to work tirelessly to care for patients during this Covid-19 pandemic.

Lots of work has also been going on behind the scenes to make sure staff are supported with the right guidance and equipment, and that we are looking after their health and wellbeing needs during this difficult time. Across Surrey Heartlands we have been working to minimise the spread of the virus through new and different ways of working – such as the provision of ‘virtual’ appointments and consultations – and to make sure we have the necessary capacity to care for patients who are suffering from Covid-19 and for their recovery and rehabilitation.

Some of the changes and new ways of working are summarised below:

Changes in general practice

Our GP practices and primary care networks adapted very quickly to new ways of working and now offer the vast majority of appointments and consultations virtually, either on the telephone or via video link. Where clinically necessary patients can see a doctor or nurse face to face, with necessary safety precautions. Practices are able to provide routine services such as dressings for elderly patients without Covid-19, immunisations for children, anti-natal checks and injections separately, making it as safe as possible for patients and staff. Practices have set up separate areas or clinics (either on their own or working with neighbouring practices) for patients who may have Covid-19 and need to be seen face to face, with appropriate cleaning taking place between patients.

Further digital developments

Video and telephone consultations have also been introduced in our hospitals, at the mental health Trust and in community services via a secure web-based platform called ‘Attend Anywhere.’ This technology has been established in the health sector for many years.  Surrey has also been selected as a pilot for a national collaboration between NHSX (the digital arm of NHS England) and Facebook to test the use of Facebook portal video devices across different care settings to connect loved ones with their families during lockdown. A number of these devices have been distributed to care homes, hospitals and the mental health trust and feedback has been really positive.

Further support to care homes

Through the Surrey Local Resilience Forum, we are providing additional support to care homes, including clinical support and training, help to secure the right personal protective equipment for staff and regular communication bulletins. Our frailty team has also been supporting the roll-out of NHS email addresses to care homes. This allows information to be transferred securely between GPs, care homes and hospital settings and is part of a wider initiative to deliver greater digital connection between care homes and wider health and care services.

Overall, a significant amount of work has been done to accelerate digital developments, much of which we hope to build on for future ways of working where appropriate.

Additional hospital capacity and the new NHS Seacole Centre at Headley Court

Across Surrey we’ve kept a careful eye on the predicted numbers of hospital beds we might need to look after patients with and recovering from Covid-19. Our larger hospitals, although extremely busy, have coped and worked hard with local partners early on to free up beds to develop enough capacity to manage the surge in Covid-19 patients.

We’ve also looked carefully at what we would need in terms of community and rehabilitation beds for patients who don’t need to be in an acute hospital and for those recovering from Covid-19, or those at the end of their life. Back in March, a cross-partner team from the NHS, Surrey County Council and the military worked together to find a temporary facility for what we call step-up/step-down care. As a result, Headley Court, an ex-military rehabilitation centre near Leatherhead is now about to open as a temporary community-style hospital providing non-critical care to patients. (See separate story).

Testing

We are continuing to scale up testing capacity in line with the Government’s strategy. Through the Surrey Local Resilience Forum we are offering testing to different groups in a phased approach. We have set up a central testing hub for keyworkers, including NHS, social care and care home staff. Our hospitals also provide a testing service for their staff directly.

In line with the latest Government guidance, we are also working with Public Health England to ensure testing of all care home residents whether they are symptomatic or not and to all patients being discharged from hospital into care homes. Testing will also be offered to anyone over the age of 65 with symptoms and anyone with symptoms who cannot work from home; those eligible are able to use the national self-referral testing site at www.self-referral.test-for-coronavirus.service.gov.uk/test-type. More information on testing is available on the Surrey County Council website here.

Our system response across Surrey

Throughout this time we have worked closely with partners across Surrey through the Local Resilience Forum (LRF). On 20th March, the LRF declared a major incident on behalf of all Surrey partners which promoted the creation of a Gold Strategic Coordination Group (SCG) led by Joanna Killian, Chief Executive at Surrey County Council with Gavin Stephens, Chief Constable of Surrey Police and Steve Owen-Hughes, Chief Officer of Surrey Fire and Rescue.

Through the SCG a number of work cells were set up to manage areas such as the welfare of vulnerable and shielded residents, temporary mortuary capacity, the communication of key messages out to residents and patients, how we procure and manage PPE supplies and most recently staff and community testing.   This has required a significant collaborative effort which all partners have gladly and generously contributed to, working in new ways and taking on new and different responsibilities where necessary.