Briefing on coronavirus (COVID-19) Thursday 16 April 2020

The situation regarding the outbreak of COVID-19 is fluid and constantly changing. This briefing provides an update on the health service response to the situation and is current on the date of issue.

Stay at home, protect the NHS, save lives,

To help reduce the spread of infection the Government guidance remains in place: everyone is being advised to stay at home and to only go out for specific purposes:

The advice is:

• Only go outside for food, health reasons or work (but only if you cannot work from home)

• If you go out, stay 2 metres (6ft) away from other people at all times

• Wash your hands as soon as you get home

Do not meet others, even friends or family. You can spread the virus even if you don’t have symptoms.

More detailed guidance can be found here: https://www.gov.uk/government/publications/coronavirus-outbreak-faqs-what-you-can-and- cant-do/coronavirus-outbreak-faqs-what-you-can-and-cant-do

Police have been given emergency powers to act if people are not following this advice. There is evidence that most people are complying with the guidance and that this is having a positive impact in slowing the spread of the virus.

Arrangements to support the most vulnerable people in the district

Comprehensive arrangements are being put in place to support people in the district who may be at greater risk if they catch the virus or because of the impact of social distancing.

Some 54,000 people have been identified through joint work across the health and care system. These people include:

• People who need to be ‘shielded’ because they have an underlying health condition which means that they could become critically unwell if the catch the virus. Local GPs and hospitals teams have been to review information from a national database to make sure the most vulnerable people have been identified and sent a letter telling them to stay at home and how to get support. More than 8000 people in the district have been identified through this process. • People who are at greater risk than the general population and may not have friends or family who can help them get basic necessities like food and medication • People who may be at higher risk because of a mental health condition that could be affected by having to stay at home. • People who are entitled to certain benefits

The Council and NHS CCG are producing a leaflet that will be directly mailed out to the district’s most vulnerable residents to keep them informed and help them to stay safe and well during coronavirus outbreak.

There is already plenty of information online about support available locally but some of our most vulnerable residents may not have access to the internet or use social media.

The leaflet will signpost to local help, support and advice, share disruptions to services and relevant information, give advice around maintaining good mental health and physical well- being and encourage people to seek medical help if they do require it.

There is a helpline for anyone who is alone and needs help with essentials like shopping and medication. The number to call is 0345 8 506 506 between 9am and 5pm, Monday to Friday. Option 3 should be chosen to make a request for support and help will be arranged.

A network of community hubs is operating to support this work and extra funding has been made available. Support packs, containing food and essential supplies for vulnerable and shielded patients, are being distributed in Wakefield. The Government has produced some additional information for people who this affects.

Translated versions of the at risk patient letters have also been produced.

Healthwatch Wakefield has produced a guide to support services, which is available on their website.

National Volunteer Responders

In addition to local arrangements to support vulnerable people, NHS and NHS Improvement in partnership with Royal Voluntary Service and the GoodSam Responders app has signed up 750,000 volunteers to a national responder scheme since 24 March.

NHS Volunteer Responders can be asked to help individuals with tasks such as • collecting and delivering shopping and other essential supplies • delivering medicines from pharmacies • driving patients to appointments • bringing them home from hospital • making regular phone calls to check on people isolating at home • transporting medical supplies and equipment for the NHS

Identity checks are carried out for all volunteers and enhanced DBS checks are carried out for those volunteering as patient transport drivers.

Royal Voluntary Service has completed security checks and the scheme is now fully operational. It is aimed at people who are at very high risk from coronavirus where no local support is available, including: • People who have been asked to self-isolate and ‘shield’ • People who are over 70 with underlying health conditions • People who are self-isolating who you consider to be especially vulnerable.

Access to the national volunteer support is via referral by any health and social care professional • GPs • Practice staff • Practice nurses • Social prescribing link workers • Hospital discharge teams • Community pharmacists • NHS 111 • Ambulance trusts • Community health trusts that need volunteer support for patients leaving hospital • Local authorities • Social care providers

The national scheme is intended to complement local arrangements and professionals are encouraged to refer people to local schemes where these are in place and working well.

GP and hospital appointments by video link

Some GP practices and hospital clinicians have switched to offering appointments by video link to help people to stay at home to reduce the spread of infection. Video consultations can be done using a smart phone, tablet or computer which is connected to the internet by WiFi, 3G or 4G. If the clinician thinks a video consultation is suitable, the patient will be sent a letter inviting them to the appointment, which includes a link to click on to access the video appointment. This will include information about how to make a test call before the appointment if it is the first time the patient has had a video appointment.

If a patient is offered a face to face appointment and is concerned about the risk of infection by attending the surgery, clinic or hospital, they should contact the service to discuss this.

Routine primary care

It is vitally important that people don’t neglect their general health at this time. Routine primary and community care services, including ante-natal and post-natal care are still available. Some extra precautions have been put in place to control the spread of the virus. This includes asking people to call their GP practice or midwife before attending the surgery or clinic. Many appointments are being managed over the telephone or by video link to support people to follow the advice to stay at home unless absolutely necessary.

The Wakefield walk in centre and the urgent treatment centre at Pontefract remain open but patients MUST contact NHS 111 before attending.

24/7 access to primary care for COVID patients

The CCG has been working with the seven primary care networks in the district to put in place 24/7 access to primary care services for people with COVID symptoms. These services will ensure people are well supported at home and that only those with more serious illness need to go to hospital.

Patients with symptoms are advised to contact NHS 111 or their own practice. Most people will be assessed over the telephone and, if they have mild symptoms, will be advised to self-isolate at home. For those people whose symptoms require a face to face appointment dedicated centres have been set up across the district. Patients with COVID symptoms will be treated in a separate area of the building to those with non-COVID symptoms.

Plans are being developed to have two centres operating an overnight COVID service – one in the West of the district and one in the East.

For all these services, patients should not attend without an appointment.

General practice home/care home visiting service

A general practice COVID-19 home/care home visiting service has been set up with the community nursing team.GP practices are working together to ensure support is maintained for non-COVID patients who need district nursing support.

Branch closures

NHS Wakefield CCG has put in arrangements to consider requests from GPs to temporarily change services to limit the spread of the virus and manage the impact of staff absences.

Currently the following surgeries are closed or partially closedand have alternative arrangements in place:

• Stanley Health Centre

Staff from the practice have temporarily relocated to Outwood Medical Centre, Potovens Lane, Wakefield, WF1 2PE. Patients can still contact the practice using the usual telephone number (01924 822328) to speak to a member of the clinical team, when they will be assessed and offered the most appropriate care or advice.

• Fryston Road branch surgery Patients should telephone 01977 552109 to speak with a memberof staff.The main surgery at the Henry Moore Clinic, remains open from 8am-6.30pm every day Monday to Friday.

• Southmoor surgery, Hemsworth The Southmoor branch surgery has been temporarily closed until further notice to enable the practice to keep services available. Park Green Surgery remains open and patients can contact Park Green Surgery on 01977 642251.

• South Hiendley branch surgery The branch surgery at South Hiendley has been temporarily closed. Patients who would usually attend the branch surgery should contact Rycroft Medical Centre on the usual number (01226 725555)

• Sharlston branch surgery

The branch surgery at Sharlston has been temporarily closed. Patients who would usually use the branch surgery should contact Crofton Health Centre on the main number 01924 862621.

Details of these changes are available on the individual practices’ websites.

Changes to hospital services

To control the spread of infection and maximise capacity to treat seriously ill patients, Mid Hospitals Trust has made significant temporary changes to its services.

Patients will be organised into three groups: COVID-19 positive; potential COVID-19 patients for whom the results of their swab tests are awaited; and those patients that are COVID-19 free. In summary this will aim to protect Pontefract and Dewsbury Hospitals to provide care to patients who do not have COVID symptoms. Many services have been temporarily moved from Pinderfields.

Management of routine and non-urgent hospital care

In line with national guidance, for the time being, the Trust will not be taking any new referrals for routine and non-urgent care. Alternative arrangements will be put in place for these patients to be supported.

The Trust will still take referrals for patients whose care needs are urgent or time- critical, including suspected cancers. These referrals will be clinically reviewed to assess whether they need to be offered an appointment or treatment within the next four months. In some cases this will involve telephone or video consultation rather than being seen face to face.

Visiting has been suspended at all hospital sites to control the spread of infection.

Arrangements for managing patients with COVID symptoms in the hospital

The number of local beds that can be used for intensive care and to support people with COVID-19 symptoms has been significantly increased. Clinical staff have been reorganised and given extra training to enable teams to work differently to manage the specific needs of patients with COVID-19.

Nightingale Hospital for Yorkshire and Humber

Additional hospital capacity is being created for . NHS Nightingale at Harrogate is a vital part of the NHS’s surge capacity in the response to the Coronavirus pandemic. Based at the Harrogate Convention Centre, the Nightingale will provide up to 500 critical care beds equipped with ventilators and oxygen. Once fully operational it will be able to provide care for thousands of patients who have tested positive for Covid-19 from across the region.

Temporary suspension of home births

The home birth service in Wakefield has been temporarily suspended to minimise possible risks to mothers and babies and to midwives. Women will be able to discuss alternative birth options with their midwife.

Mid Yorkshire Hospitals NHS Trust cancer helpline for patients

Oncology 24 hour helpline: 01924 546272

If patients have questions about chemotherapy treatment or appointments they can call one of the chemotherapy units:

• Pontefract Chemotherapy Unit – 01977 747130 • Dewsbury Chemotherapy Unit – 01924 542244 • Pinderfields Chemotherapy Unit – currently closed

For any other enquiries patients can call the cancer helpline available every day from 8.30am to 4.30pm. More information can be found on the website

Testing

The Government has announced a significant increase in testing to include staff working in non-NHS care services. Testing arrangements for NHS staff across Calderdale, Kirklees and Wakefield have already been set up. Tests will be offered to staff who are self-isolating because they or a family member have symptoms to enable them to return to work once they have confirmed they are not COVID positive. Priority will be given to those staff where their ability to return to work promptly will have the greatest impact.

In Wakefield, access to testing is already being offered to staff working in care homes as well as to NHS staff.

Personal protective equipment

There has been a huge amount of coverage in national and local media about access to Personal Protective Equipment for staff working in hospitals and in the community. National guidance is being updated frequently.

Local co-ordination and support arrangements have been put in place by Wakefield Council and NHS Wakefield CCG who are working proactively with out- of-hospital services, including GPs, care homes and hospices and a PPE Hub has been set up to supply emergency top ups to services that are running low on equipment. General access to supplies appears to be slowly improving.

Mental health support

South Partnerships NHS Trust has made changes to its services to ensure it is able to continue to support patients with mental health and learning disabilities and support people to limit their risk of infection.

The trust is also developing services to respond to people whose mental health is affected as a result of social isolation measures. Detailed information is available on their website. https://www.southwestyorkshire.nhs.uk/coronavirus/coronavirus-and-our-mental-health- and-wellbeing/

An easy read guide to looking after your feelings and your body is also now available.

West Yorkshire Police Complaints Commission extra-ordinary grant

The West Yorkshire PCC has launched an extraordinary grant aimed at keeping communities safe through the pandemic. The grant round closes on 1 May and is specifically for projects and interventions which target domestic and sexual abuse, child sexual abuse, mental health, fraud and drugs/alcohol services.

Grants are for up to £6,000 for outcomes to be delivered over 6 months from a total pot of £150,000

Details can be found here:https://www.westyorkshire-pcc.gov.uk/news- events/news/pcc-launches-extra-ordinary-ps150000-grant-round-help-support- communities-with-impact-covid-19

Number of people affected by COVID-19

Public Health England publishes a daily dashboard showing the number of people affected by COVID-19

Ash Grove surgery rated ‘good’ by Care Quality Commission

Ash Grove surgery in Knottingley, which has been receiving support from the CCG and neighbouring practices in the primary care network since being rated ‘requires improvement’ by the CQC, has been rated ‘good’ following an inspection in March 2020. The full report can be viewed on the CQC website.

Correct as at 16 April 2020