Tag: pressure on services

HEALTH CRISIS: NHS Lothian is ‘stretched beyond capacity’

Hospitals and GPs in Lothian are being stretched beyond capacity as a result of sustained and intensifying pressures, NHS Lothian has warned.

Speaking in Tuesday, Calum Campbell, Chief Executive, NHS Lothian, said the healthcare system was under extreme duress as a result of an increase in the numbers of emergency patients, large numbers of delayed discharge patients and an increase in respiratory illnesses.

He said teams at the Royal Infirmary of Edinburgh, St John’s Hospital, the Western General Hospital and the Royal Hospital for Children and Young People were all being pushed to the limit.

To help free up vital beds, he said that some relatives may be asked if they can provide care to their loved ones as an interim measure while those packages of care to help in their own homes are put in place by their local Health and Social Care Partnership.

He said: “These challenges are unprecedented, but they are also sustained. We need people in Lothian to help their own communities and the NHS.

“We have large numbers of people waiting to be admitted into a hospital bed, so I would urge everyone who is asked to provide care to their loved one to give the request some serious consideration.”

Dr Tracey Gillies, Medical Director, NHS Lothian, said: “Our teams will have carried out a robust clinical assessment before they discuss the temporary possibilities with patients and their families.

“We know that most patients want to return home as soon as they possibly can, especially at this time of year. This would also help our teams and the patients waiting to be admitted.

“Also, if you have a loved one in hospital who has been discharged and requires to be collected, please do so as early in the day as possible.”

The primary care sector in Lothian also experienced one of its busiest days to date on Monday (19th December) as they provided care to increasing numbers of adults and children, especially families with concerns around Strep A following recent increases in the virus.

Jenny Long, Director of Primary Care, NHS Lothian, urged people to remember that there were a number of winter viruses in circulation and to consider NHS Inform and their local pharmacist for help and advice, use over the counter medication, drink plenty of fluids and rest.

Cold-type symptoms such as a runny nose or mild cough are more likely to suggest a viral illness.

If you have a sore throat, but can eat and drink, and don’t have a very high temperature then it is likely to be a common virus and there is no need to contact your GP.

The most up to date information on Strep A can be found at 

https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/streptococcus-a-strep-a/.

‘Test to Release’: England’s frontline health and care staff can work rather than self-isolate

Frontline NHS and social care staff can attend work rather than self-isolate with testing mitigations in exceptional circumstances under updated guidance announced this morning.

From today (Monday 19 July), double vaccinated frontline NHS and social care staff in England who have been told to self-isolate will be permitted to attend work in exceptional circumstances and replaced by testing mitigations.

This will include staff who have been contacted as a close contact of a case of COVID-19 by NHS Test and Trace, or advised to self-isolate by the NHS Covid-19 app.

This measure is being introduced to alleviate pressure on NHS and social care services and will be contingent on staff members only working after having a negative PCR test and also taking daily negative lateral flow tests for a minimum of seven days, and up to 10 days or completion of the identified self-isolation period.

This measure is being introduced to alleviate pressure on NHS and social care services and will be contingent on staff members only working after having a negative PCR test and daily negative lateral flow tests.

The government is clear the change applies only to frontline NHS and social care staff where their absence may lead to a significant risk of harm.

The decision to allow NHS and social care staff to attend work after being told to self-isolate should be made on a case-by-case basis, and only after a risk assessment by the organisation’s management.

This must be authorised by the organisation’s local Director of Infection Prevention and Control, the lead professional for health protection, or the Director of Public Health relevant to the organisation.

Health Secretary Sajid Javid said: “As we learn to live with this virus, it’s important that we ensure frontline staff can keep providing the best possible care and support to people up and down the country.

“The government has backed healthcare services at every turn through this global pandemic and these new rules will fortify our collective defences against this awful virus, by allowing fully vaccinated frontline NHS and social care staff to continue to work when needed.”

Careful consideration should be given by local NHS and social care organisations to the risk of onward transmission compared to the risk to delivery of critical services.

Staff who are permitted to attend work will remain under a legal duty to self-isolate as a close contact when not at work, but will be considered to have a ‘reasonable excuse’ under the Self-Isolation regulations to leave self-isolation to attend work where their absence could result in harm. They will continue to receive self-isolation reminders.

UK Health Security Agency Chief Executive, Jenny Harries, said: “With the number of cases continuing to rise, it is imperative that we do everything we can to manage this virus and support our NHS and social care services under the strain of increased demand and sustained pressure.

“We have provided specific guidance to NHS and social care settings for circumstances where there is a significant risk to health or safety resulting from staff absence or a critical service cannot run.

“This measure only applies to double vaccinated staff, who will only be able to attend work after testing negative on PCR and daily lateral flow tests, and following a risk assessment and the supervision of the health service.”

In order to mitigate the increased risk associated with attending work, the following mitigations must be implemented:

  • The staff member should be fully vaccinated, defined as having received both doses of an MHRA approved vaccination, with 14 days having elapsed since the final dose.
  • The staff member should undertake a PCR test and should self-isolate until they receive the result. They should only attend work if this result is negative.
  • They should undertake daily LFD tests prior to starting work each day. Test results should be reported to NHS Test and Trace via the web portal and to their duty manager. Any staff member who has a positive LFD test during this period should not attend work and should arrange a PCR test as soon as possible.
  • If the staff member develops any COVID symptoms, they should stay at home and immediately arrange a PCR test.
  • Staff working during this 10-day period should comply with all relevant infection control precautions and PPE should be properly worn throughout the day. Any breaches should be reported immediately to their line manager.
  • The staff member should not work with clinically extremely vulnerable patients or residents, as determined by the organisation.

Existing guidance will be updated by Public Health England today (Monday 19 July), and shared with NHS trusts and relevant social care organisations across England.

These changes apply in England only. The Scottish Government will announce any changes to exisiting arrangements, if necessary, in due course.