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Southern Health NHS Foundation Trust Southern Health Covid-19 Service Changes

Changes to our service

24 June 2020

Changes to services

Due to the current and ongoing coronavirus pandemic, we are having to adapt our services to keep pace with the fast evolving situation, to follow Government guidance (so we can increase our capacity for anticipated demand) and, most importantly, to protect our patients, staff and local communities.

As a result of the national crisis, we've had to make temporary changes to some of our healthcare services. To provide the safest and best possible service to our patients during these challenging times, we are increasingly making use of technology (such as video or telephone appointments and online resources) to support our staff and to ensure ongoing contact with our most vulnerable patients. In some circumstances, we are postponing routine appointments and treatments in order to be able to redeploy some of our staff to areas where their skills are most needed.  

Please bear with us during these unprecedented times, we apologise for any changes to your care and would ask you to contact your local team if you have any questions.

Hampshire wide:

Below is a list of some key services which, during 'phase one' of our response to the pandemic (from late March 2020), temporarily had to change the way they operate:            

       
  • Children's and families service  (i.e. health clinics, group work) - all non-essential face to face visits have stopped and services are being offered digitally (other digital services also include the Hampshire Healthy Families website, Hampshire Healthier Together, ChatHealth, webinars for group information for parents i.e. Five To Thrive). The service is continuing to offer support to vulnerable families through home visiting and telephone/video support (including where there are safeguarding concerns).
  • Complaints: there is a ‘pause’ in the NHS complaints process (for three months until normal service resumes in July) – although we will ensure that people are still able to raise concerns or make a complaint (and all complaints will be logged, triaged and acknowledged).
  • Diabetes services: have moved to a single team across all sites to maintain a safe service. Group education is cancelled and the team are replacing this with videos and webinars. Face to face appointments have also been cancelled (many will switch to telephone reviews).
  • Electro-Convulsive Therapy (ECT): these services will temporarily operate from a reduced number of sites, (reducing from three sites to two, or potentially one if necessary).
  • italk services: face to face sessions have been cancelled and replaced with virtual appointments.
  • Learning disability services: all non-critical face to face community visits have ceased although staff are maintaining regular contact (using the phone or video conferencing) with all high risk service users and are providing critical support where necessary. Routine referrals are currently being declined (until the team returns to business as usual) and are instead being directed to a referrals hub for guidance. Willow Ward has remained open as a priority service.
  • Outpatient services (in particular musculoskeletal services): patients who cancel appointments will be discharged but able to self-refer back into the service at any point over the next 12 months.
  • Psychological services across the Trust have been moved where possible to video/telephone contact, this includes: older people’s mental health, eating disorders, adult mental health, early intervention in psychosis, crisis resolution   and home treatment and community mental health teams.
  • Routine therapy will temporarily cease - Podiatry, Hand Therapy, Pain Service, MSK (instead providing a telephone service for triage, advice and discharge). 
  • Secure adult and CAMHS services: all inpatient services have continued to run, although new admissions are being reviewed for clinical appropriateness and impact on any Covid19 cases. Some community based services (including the Community Forensic Learning Disability Team) have reviewed treatment plans and decided which can be temporarily stopped and which need to continue. Others, like the Specialist Community Forensic Team, have reviewed what can be undertaken as telephone contact and what needs to be completed face to face. The Prison Community Mental Health Team is continuing contact with HMP Isle of Wight prisoners (with our medic dialling into multi-disciplinary team meetings) whilst our stalking support service is continuing treatment via phone/teleconference (instead of face to face). The Hampshire Multi-Agency Personality Service (HMAPS) has changed from face-to-face to online (phone and video) contact, with a minimum of weekly calls to patients. 

These services have reduced in frequency (based on national guidelines during the pandemic). These include:

  • bowel care
  • catheter care
  • depot injections (for Prostap, Denusomab, Epoetin and Zoladex)

  • dressings for wound therapy

  • essential rehabilitation for discharge

  • CHC fast-track provision assessments

  • nephrostomy (urinary tubes/bags) care

  • PICC lines (peripherally inserted central catheter)    

  • vitamin B12 injections.


The following services have temporarily stopped (in line with national guidelines):

  • Blood testing (routine)

  • Dexa (Bone Density) Scanning

  • Diagnostics - Outpatient Routine  (i.e. 24 hour tapes, plain film x-ray, MRI, CT, ultra-scan)

  • CHC Applications (for nursing home placements)

  • Continence Assessments

  • Deliveries - Medicine or Dressing

  • Dietetic Clinics

  • Endoscopy (routine)

  • Falls Assessments Clinics and Classes

  • Medical Outpatient Departments (i.e. respiratory, cardiology, medical, ENT)

  • Orthopaedic Choice (except urgent triage)

  • Pulmonary Rehabilitation

  • Parkinson’s Routine Clinic  

  • Pressure Ulcer Panels

  • Rehabilitation in the Community (routine)

  • Stroke Assessment - 6/12 follow-up

  • Wound Clinics - routine  (however self-care packs in relation to wound care will be given to all care home. 

 

North and Mid Hampshire 

    Beechwood ward (a mental health ward for older people at Parklands Hospital) has temporarily become a ward for adult/older people with mental health issues who require physical health care for COVID-19.  It has been operating in this capacity as an 18 bedded ward since Monday 6 April 2020.   
               

Portsmouth and South East Hampshire

  • Continence (face to face appointments) have now stopped.

  • GP routine appointments including health checks, routine smears, annual reviews (ie diabetic, respiratory, routine blood tests, travel vaccinations, face to face routine consultations/medication reviews) are cancelled

  • Nursing home forums/group sessions are cancelled

  • Mental health liaison team has temporarily changed location and is undertaking assessments and triaging by telephone, with minimal face to face contact

  • MS (face to face consultations) have stopped

  • Oxygen assessments (routine) have stopped

  • Parkinson's appointments (face to face consultations) have stopped. 

  • Respiratory routine appointments have now temporarily stopped.

  • Stoma appointments (face to face consultations) have stopped. 

  • Urology appointments (face to face consultations) have stopped. 


South West Hampshire

  • Diagnostic upper or lower GI endoscopy (routine) in Lymington Hospital has stopped

  • ENT will only accept urgent medical referrals and will also offer phone consultations (patients with suspected cancer should follow the local 2 week wait pathway)

  • Ford Ward - a 15 bedded rehabilitation unit based at Fordingbridge Hospital – was temporarily merged with Romsey Hospital (from 10 April) to support the clinical need for patients requiring a Covid19 recovery ward. We are planning to restore Ford Ward w/c 11 May 2020 (as the demand for the rehabilitation pathway reinstates)     
  • Gastro services are now closed at Lymington Hospital

  • MRIs (routine) are being cancelled for those over 70 years old

  • Rhueumatology is closed at Lymington Hospital

  • Spirometry and pulmonary function tests (PFT) have ceased

  • Ultrasound routine appointments have stopped

  • Ultrasound guided injections have stopped

  • Xrays are moving to bookable appointments only (patients should phone Lymington Hospital on 01590 663110 - 24 hours after a GP referral - to book their appointment). 

     

Southampton
    The Lighthouse (run in partnership with Solent Mind) is temporarily running as a ‘virtual’ crisis lounge, as the premises in Shirley are too small to maintain safe social distancing. 

For Southampton residents, simply text LIGHTHOUSE and your postcode to 07451 276010 between 4.30pm and 12am to access the service. 

Phase 2 (June 2020 onwards)

Following all these changes (above), we have now moved into ‘phase 2’ of our response to the pandemic. Our focus now is on both restoring services that have been paused or reduced in any way as part of our original crisis response, together with expanding those services which are likely to see a significant increase in demand as a consequence of the pandemic. At the same time we are working to ensure flexibility to respond to any further outbreaks of the virus.

Throughout the pandemic, we have been (and continue) working with our staff, patients and carers across Hampshire to ensure our local communities have access to our services, especially those needing urgent or ongoing support. Whilst the methods for delivering care may have temporarily changed, the vast majority of the care we provide is still available for people to access.

However, as the first wave of the pandemic eases, there are a number of pressures that remain to be managed. These include the backlog of routine care appointments, the impact of isolation and stress on the local population’s longer term mental health (and the impact of this on our services), and of course the welfare of our staff who have been working longer and harder than ever before.

Work that is already underway to begin restoring services as part of phase 2:

  • A review of patient caseloads is underway.
  • We are reviewing all the work that we stopped doing and what the impact has been.
  • We are undertaking an evaluation of service changes from a patient and quality impact perspective.
  • Where possible, we are starting to recommence services using a clinically led risk-based approach.
  • We are planning to increase capacity in mental health services.
  • A rapid evaluation of all the digital innovations we’ve introduced is underway.
  • We have met as a Board and are resetting our Trust’s priorities/operating plan in light of the pandemic.
  • We are working closely with partners to remove red tape wherever safe to do so, as part of a ‘one team’ approach.
  • We are putting in place longer term support for our staff’s health and wellbeing.

 

Visiting Guidance

Based on national guidance, we have new visitor guidance across our inpatient wards from Monday 29 June 2020.

  • Each inpatient can now have 1 person visit them for 1 pre-booked visiting session (of no more than 1 hour) per week. Where possible, this will take place outside in hospital grounds.
  • Rules for the partners of those mothers staying in our Mother and Baby Unit at Melbury Lodge are different due to the opportunities they need to bond with their baby. Speak to staff at the unit directly about this.
  • Being with a loved one at the end of their life constitutes a special circumstance and, wherever possible, people from the immediate family should be able to be with their loved one (as long as they follow the PPE guidance from staff).


Regarding patient leave in mental health inpatient units, there is still no unescorted leave, but escorted leave can now be increased up to 60 minutes per day.
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