Hospital nurses are reshaping a specialist service to keep hundreds of patients most at risk from Covid-19 safe during the pandemic.

The Home Ventilation team, based at Castle Hill Hospital, supports more than 300 people with severe health conditions affecting their breathing such as Chronic Obstructive Pulmonary Disease, Motor Neuron Disease, Muscular Dystrophy or spinal injuries. People with very high BMIs who experience breathing difficulties are also part of the group.

Every single person helped by the team is classed as “Extremely Clinical Vulnerable” because Covid-19 poses such a danger to their life and most have been shielding for a year to ensure they do not catch the virus.

Our Home Ventilation Team: (from left) Sarah Constable, Halina Voss-Palmer, Diane Murray and Olivia Hardwick

Diane Murray, who leads the team of three nurses, said the service has introduced virtual clinics and socially distanced face-to-face sessions as well as increasing home visits to patients throughout East and North Yorkshire as well as Lincolnshire to keep them safe and as well as possible.

She said: “They are a very vulnerable group of people and dealing with their conditions during Covid-19 has been very challenging.

“Life has got a lot more complicated for us and our patients, most of whom already on ventilators.

“Our workload has changed significantly and we’ve introduced new ways of working to make sure everyone is as safe as possible.”

Virtual clinics have been introduced so patients don’t have to come to hospital as often for check-ups. However, some patients still have to be seen in person to check their readings or their blood gases and collect data from their equipment.

Patients who have to come to Castle Hill Hospital are seen in a socially distanced environments with full infection prevention and control measures in place, with them and staff wearing the appropriate personal protective equipment (PPE) to keep everyone safe.

However, the team still have to carry out home visits for some patients to carry out what is known as “aerosol generating procedures” such as home mechanical ventilation or cough-assist.

These procedures can be dangerous if the patient has the virus because they can produce infected droplets in the air so the team must wear enhanced PPE including special respirator masks, gowns, gloves and visors to keep them safe.

Diane said: “There’s a lot of “doffing and donning” of PPE on people’s doorsteps these days but it’s what we need to do to keep us and our patients safe. This is particularly challenging in the wind and rain. Patients and families need some clear explanations of why we are wearing the level of PPE that they see on the television in ICUs and Covid Wards when we are in their homes.

“They have all been supportive and appear reassured by the measures we are taking to keep them and us safe.

“We’ve received our vaccine now so we’ll have that added layer of protection and our patients have also started receiving the vaccine too because of their clinical vulnerability. We still have to take the precautions with wearing PPE and distance where possible due to the high risk nature of some of the procedures we are performing.

“Sometimes, when we go into the homes of these patients and sit on their sofas, we are the first people they have seen in a very long time because they’ve been shielding at home.”

Diane said patients shouldn’t be worried about coming to hospital for their face-to-face check-ups because of the measures put in place to keep them safe.

“If anyone is worried, I’d ask them to contact the team so we can talk them through the process. It’s really important people keep their appointments and we can always make alternative arrangements for those who aren’t able to come to hospital.

“We also advise our patients to try and wear a mask or face shield if they do have to go out of their homes- they shouldn’t assume because they have a condition that affects their breathing that they cannot wear a mask. Many of our patients are still able to wear masks for short periods and this will help keep them safe.

“Covid-19 is changing how we work and it’s going to be with us for some time yet. The numbers are still higher than the national rate in the areas our patients come from but we are making these changes to keep everyone as safe as possible.”

The Home Ventilation Service can be contacted by calling 01482 624130. You can also email hyp-tr.huth.hmvs@nhs.net to get in touch with the team.

Patients are to be discharged home or to a community facility as soon as they are well enough to stop them spending too long in hospital.

Hull University Teaching Hospitals NHS Trust is introducing the new “Discharge to Assess” system so people can leave Hull Royal Infirmary as soon as they are well enough instead of spending longer than necessary in a hospital bed while their future needs are assessed.

Trust staff are working with Hull City Council, East Riding of Yorkshire Council and City Health Care Partnership (CHCP) to introduce the new scheme, initially for elderly patients treated in hospital for medical conditions.

Emma Smith, Head of Discharge Liaison Services at the trust, said: “This new system means patients will get the very best care in the most appropriate place for them because they will no longer be kept in hospital once they are well enough to leave.

“Research proves people, particularly the elderly, can suffer muscle wastage causing problems with mobility and leading to future hospital admissions, all of which affect their ability to live independently, if they spend too long in a hospital bed.

“Now, they will be moved into temporary facilities in the community or back home as soon as they are well enough so full assessments are carried out by social workers and therapists to make sure they get exactly what they need.”

Christy Francis, Deputy Chief Operating Officer at CHCP, said: “The local health and care system has worked collaboratively with all agencies to ensure that everyone who leaves hospital after an illness or injury is provided with the right level of support.

“This will ensure good recovery after discharge and help regain independence and remain at home. Together, we will work to ensure that everyone who has been admitted to a hospital bed has the opportunity to return back to their own bed at home.”

Between 180 and 200 patients are discharged from Hull Royal Infirmary and Castle Hill Hospital every day. Around 15 per cent of those require additional support, such as social care packages to help them stay at home or round-the-clock care in a nursing or care home.

Previously, patients had to stay in hospital – even when they were no longer in need of care from medical and nursing staff – while assessments were carried out on what support they may require to continue to live independently.

They also had to remain in hospital, often for weeks, while families worked with social services to find suitable residential places in care or nursing homes if they were no longer able to remain in their own homes.

New guidance and funding has been introduced by the Government to speed up the process and remove some of the barriers involved in discharging patients efficiently from hospital.

Not only will the new system prevent people spending too long in hospital, it will also benefit those forced to wait for surgery because of the pandemic as more beds will be available to care for more patients with staff free to look after those with serious conditions.

Patients will be encouraged to talk to nursing staff about the opportunity to have assessments carried out in the familiar surroundings of their own home rather than wait longer in hospital for it to be carried out.

Over the next few months, patients admitted to some wards at Hull Royal Infirmary will be treated, monitored and assessed by doctors on daily ward rounds throughout their stay until they are well enough to be discharged. Once they are ready to be discharged, they will be referred to a new team.

This team will aim to help 95pc of patients return to their own home to benefit from assessments carried out in familiar surroundings, with therapists and social workers able to assess how they manage and what additional support they may require to continue to live independently.

The remaining 5pc may move into a community facility such as a care home for a short period until their needs are assessed by specialist staff.

Additional care and support such as help with shopping, meals or washing and dressing will be free for up to four to six weeks after a person is discharged from hospital. This will allow patients and their families time, free from financial constraints, to work with social services and therapists to select a more permanent care facility for their loved one or longer-term support at home.

Patients admitted to the  Department of Elderly Medicine at Hull Royal will be the first to take part in the scheme but may be rolled out to other areas over the coming months.

A Hull hospital team has made a major contribution to research indicating that patients with Inflammatory Bowel Disease on a commonly used medication may not mount adequate immunity and immune memory if they contract Covid-19 or following their first dose of the vaccine.

Professor Sebastian (pictured below) and his team at Hull University Teaching Hospitals NHS Trust co-led  the CLARITY study of 7,200 patients with Crohn’s disease and ulcerative colitis from 92 hospitals in the country.

The study discovered fewer than half who receive the drug Infliximab had detectable antibodies after catching the virus, suggesting the treatment had blunted the immune response to infection.  In a second paper, currently in review, they describe the same effect following vaccination for Covid-19, particularly if patients were being treated with Infliximab as well as an immunosuppressant such as azathioprine.

Professor Sebastian and his team co-led the CLARITY study

Professor Sebastian, the lead consultant in Inflammatory Bowel Disease (IBD), said CLARITY was the first study involving these clinically vulnerable patients which has raised some concern about their immune response.

He said: “The good news is that almost all patients had a boost in immune response after the second dose or after the first dose if they had been infected with Covid-19 before.

“Overall, it appears that these patients need more than one challenge – either with two doses of vaccines or at least one dose in those who had previous infection.”

He said it was important that people with IBD continued their medication and took up the offer of vaccine as the evidence suggested their outcomes if they caught the virus were better.

“We and others across the world are now looking at whether further booster doses are required in some patients by measuring their antibody levels over time after vaccination and specific immune cell functions,” said Professor Sebastian.

“I am grateful for our patients who are participating in this ongoing study and also the excellent integrated IBD team, in particular research nurses Alison Talbot, Sally Myers, and Jack Turnbull.”

The Hull team recruited 330 patients with IBD, the most recruited by any of the hospitals taking part in the study led by the Royal Devon and Exeter NHS Foundation Trust and the University of Exeter Medical School. The study was also supported by Crohn’s and Colitis UK and the UK National Institute for Health Research (NIHR).

Around half a million people in the UK live with IBD and many have been shielding since the start of the pandemic.

Sarah Sleet, Chief Executive Officer at Crohn’s and Colitis UK, said: “The CLARITY results are an important first step in helping us understand how different medicines for Crohn’s and Colitis affect a person’s response to coronavirus.

“At this stage, the key message is people with Crohn’s and Colitis should keep taking their medication to stay well and take the vaccine when offered. But we also need research like this to continue.”

Hospital staff on a Covid ward have spoken of their work to care for patients with cancer who develop the virus.

Ward 30, an oncology ward at the Queen’s Centre, looks after patients with complex symptoms of cancer.

However, during the pandemic, the ward team have been looking after patients with cancer who have also been diagnosed with the virus.

Ward Sister Hayley Butler said her entire team, including nursing staff, housekeeper and hygienist, ward clerks, cleaning staff and caterers as well as members of the multi-disciplinary team looking after patients, stepped up to the challenge.

She said: “Treating patients with Covid-19 and cancer has been really challenging but the team has embraced the challenge and, as always, the patients have been our main priority.

“The whole team have been amazing and have worked so hard to ensure all the patients received a really high standard of care.”

Hayley said as well as dealing with the medical and nursing requirements of patients with both cancer and Covid-19, her team has been looking after the emotional needs of people separated from their loved ones by the need to keep them as safe as possible during their time in hospital.

She said: “The commitment shown by the whole nursing team has been phenomenal and the team have gone above and beyond on so many occasions to ensure the patients received the care they needed alongside addressing their emotional needs because they were parted from their families.

“Coping with cancer for our patients is hard enough but to have to cope with Covid-19 as well is so hard emotionally.

“The whole team bridged the gap for the patients and the feedback from the patients and their families was such an amazing testament to the high standard of care given to all the patients.”

Hayley also thanked staff from other areas of Hull Royal Infirmary and Castle Hill Hospital who had been redeployed to help on the ward during the three waves of the pandemic.

She said: “They’ve come from different areas and that must have been unnerving for them because they weren’t used to our ward.

“But they’ve been absolutely fantastic. They may have moved on from our ward but I want them to know we couldn’t have done our work without their support and dedication to their jobs.”

She also thanked those members of the ward team who have gone on to work in different roles at the trust.

In a direct message to the team, Hayley said: “It doesn’t seem enough but I want to say a really big thank you to every single member of the ward 30 team – the care and compassion you have all shown to all of our patients has been truly outstanding.

“You have all supported each other so much too and how you have all adapted to change is truly inspiring.”

Hull University Teaching Hospitals are to take part in a new trial to understand what happens when people receive different vaccines to protect them against Covid-19.

The study will follow volunteers over the next 10 months to see if there is any benefit to a person’s immunity when they receive different forms of the vaccine.

Researchers at Hull Royal and Castle Hill Hospital are aiming to recruit local people to the trial, particularly those from BAME communities, to take part in the mixed vaccine study.

Priyai Parkinson, Research Delivery Lead at Hull University Teaching Hospitals NHS Trust,  said: “We are looking for volunteers to take part in a study to see what happens in the immune system when a second (boost) dose of Covid-19 vaccine is a different type to the first.

“We are looking for people who have already had their first dose of Covid-19 vaccine through the NHS vaccine roll out programme.

“If you are aged 50 years and over, and have received only one dose of Covid-19 vaccine from the NHS vaccine programme so far, then you may be eligible to take part in the study.”

The trust played a major part in the trial of the Oxford Astra Zeneca vaccine last year, one in every 45 participants recruited by the Hull team.

Adult volunteers of 50 years and older who have received one dose of either the Pfizer or AstraZeneca vaccine in the last eight to 12 weeks are being invited to take part in this latest trial, led by the Oxford Vaccine Group, part of the University of Oxford.

Those taking part in the randomised trial will either receive a booster dose which is the same as their initial injection or they will receive the Novavax or Moderna vaccine.

If you are interested in finding out more, visit www.comcovstudy.org.uk/participate-hull-comcov2 where you can access the Study Information Booklet.

Email hyp-tr.huth-comcov2trial@nhs.net if you would like any further information about the study.

Women are being encouraged to attend breast screening appointments when they receive their three-yearly invitations.

Humberside Breast Screening Service is reassuring women that full safety measures and social distancing have been put in place to protect them when they attend all appointments.

Screening sites are based at Castle Hill Hospital and Withernsea Hospital. The site at Freshney Green GP Practice will soon be moving to St Hugh’s Hospital in Grimsby while the site at Tesco’s car park in Barton will move soon to Goole Hospital.

There is also limited availability at the Pink Rose Suite at Diana, Princess of Wales Hospital in Grimsby.

Staff working for the service are trying hard to offer women appointments as close to their registered GP practices as possible and extra screening clinics have been introduced at the Breast Care Unit, Castle Hill Hospital at evenings and weekends to offer women more choice.

Lesley Peacock, Programme Manager for the service, said: “Women should be assured that we’ve put everything in place to keep them safe when they come for their appointments. We’ve been operating the service throughout the pandemic so we know how to keep everyone as safe as possible..

“People coming for their appointment will need to wear a mask and our staff will be wearing appropriate PPE as part of our safety measures and we’d like to thank everyone for their understanding and cooperation.

“We’d appeal to anyone who is worried about attending their appointment to speak to us if they require further reassurance.

“Similarly, if any woman is not able to make her appointment, we’d urge them to get in touch with us as soon as possible to cancel their booking so we can offer their appointment to another woman.”

You can contact our team by emailing Humberside.breastscreening@nhs.net or calling 01482 622300. Press option 1 for changes of appointment and general enquiries.

Women will now be able to bring their partner or one adult to antenatal appointments and growth scans at Hull Women and Children’s Hospital from today (Monday, April 12).

Hull University Teaching Hospitals NHS Trust is bringing forward a relaxation of restrictions, originally planned to be introduced over the next few weeks, in line with national guidelines.

From today, women attending the Antenatal Day Unit will be able to bring one adult with them to the department.

Women attending scans to check on the growth of their baby throughout their pregnancy will also be able to bring their partner or another adult from today.

Women attending appointments at the Antenatal Clinic from today onwards will also be able to bring one adult to support them.

Restrictions for appointments with community midwives and GPs remain in place for the time being and the existing rules for visiting our antenatal and postnatal wards, as well as the measures in place for women in labour, are unchanged.

Head of Midwifery Lorraine Cooper said: “We were able to relax restrictions and allow women to bring one adult to their dating scan, usually around 12 weeks into their pregnancy, from last week.

“We’re now pleased to ease restrictions further to allow women to bring their partner or one adult with them for other appointments to reflect the lower Covid-19 infection rates in our city and across the country.

“We ask women not to bring children to their appointments to allow us to maintain social distancing and keep staff and all women attending our hospital as safe as possible.”

They already had a challenging task, ensuring patients could go home from Hull Royal Infirmary and Castle Hill Hospital with all the support they need.

But the Medical Patient Discharge Assistants have gone the extra mile during the pandemic, making sure people are tested for Covid-19 so they are well enough and safe enough to go back to care homes and their own homes.

Now, Patient Flow Managers Samantha Daintith and Ashleigh Jaffray are paying tribute to the 24-strong team, formed around six years ago.

Just some of our Medical Patient Discharge Assistants

Samantha said: “Before Covid-19, the role to maintain the flow of patients within the trust was challenging as we had to make sure people were not in hospital longer than they needed to be and to make sure we had enough beds for people who were so sick they needed to come into hospital.

“Then the pandemic took hold in the UK and the role became even more of a challenge but the team adapted and moved to different areas of the trust to suit the needs of the service.”

The team covers patients requiring care and treatment for medical conditions at both Hull Royal Infirmary and Castle Hill, including specific specialties such as cardiology. Two new members of staff will be joining shortly.

Patients must be tested for Covid-19 before they can be discharged to care homes and some require the support of social services from Hull City and East Riding Councils, meaning an additional effort by the Discharge Assistants to get people out of hospital in the safest way as soon as possible.

Ashleigh said: “The Discharge Assistants have stepped up and gone above and beyond their duties and their roles.

“Staff throughout the trust have now recognised how much of a valuable role the Discharge Assistants are and we would like to thank the team for all the hard work they do, day in day out.

“They live out the true meaning of “TEAM” – Together Everyone Achieves More – at their jobs every day.”

Frontline hospital staff helping people in need of emergency care throughout the pandemic have been praised for their dedication to patients.

Staff in the Emergency Administration Department have worked around the clock in the Emergency Department (ED) at Hull Royal Infirmary, featured in Channel 5’s A&E After Dark, since the pandemic was declared a year ago.

Team leader Jo Hagues said: “I am so proud of how the team have worked over the past year.

“They have been flexible, professional and supportive of all their colleagues even when faced with distressing situations.

“They have gone above and beyond as a team ensuring patient and colleague safety at all times.”

Last Spring, in the run-up to Christmas and at the start of the third lockdown in January, the Emergency Department has seen an influx of patients with the virus as well as those with other severe illnesses and injuries.

Staff in the Emergency Administration Department have manned all areas of ED including Children’s A&E, Primary Care, Initial Assessment, the Acute Medical Unit, Majors – where those with the most serious illnesses and injuries are taken – and the newly built block behind the tower block, where patients suspected with the virus are taken for assessment.

Supporting emergency clinicians, the team process patients’ details, book people in to be seen by clinical staff and ensure each patient’s history is ready for the doctors beginning their care.

In full PPE and often working behind screens, staff in the Emergency Administration Department have gone out of their way to help patients by dealing with them in a timely and efficient manner, despite the pressures of working in a busy Emergency Department.

The team has also supported and trained new staff and those redeployed from other parts of the hospital to help on the frontline.

Jo said: “Our team have been on the front line of the pandemic since the very beginning and they have worked together to look after patients from the minute they arrive in the department. They are a credit to our organisation.”

A new “Pod” structure  has been installed inside Hull Women and Children’s Hospital to create additional safe space allowing partners to attend scans and appointments.

Hull University Teaching Hospitals NHS Trust has been working for months on potential solutions to allow partners to accompany women to scan and antenatal appointments in line with new national guidance.

Head of Midwifery Lorraine Cooper said: “Our focus has been on keeping the women and babies in our care, as well as our own staff, as safe as possible in line with social distancing measures to prevent the spread of this deadly virus. For women not to have their partners with them at every appointment has caused some women and their partners great distress and we’re sorry for that.

“We have worked with our Estates teams and have created extra space which would allow one named partner to be with women for future scan and antenatal appointments.”

Maternity services at Hull University Teaching Hospitals NHS Trust are pleased to announce some relaxing of restrictions for visiting the ultrasound department and the outpatient department.

• From today (Tuesday 6th April), women attending the Women and Children’s Hospital will be able to bring one adult to their dating scan (usually undertaken around 12 weeks of pregnancy) and to scan appointments at the Early Pregnancy Assessment Unit
• From Monday 19th April, women attending the Antenatal Day Unit will be able to bring along one adult to the department
• From Thursday 29th April, women attending for growth scans throughout their pregnancy will be able to bring one adult to accompany them to their scan
• From Monday 17th May, women attending the Antenatal Clinic at the hospital will be able to bring one adult

These changes are possible due to the falling number of cases of Covid-19 in our area along with some extra precautions in place such as extra screens and the use of a remote buzzer system, similar to those used in some restaurants, to allow women and the person with them to maintain safe social distancing whilst waiting in the hospital.

Partners or the person with the woman is asked to continue to wear a face mask or covering and to wash your hands regularly.

Currently, the visiting arrangements on the Labour Ward, the Fatima Allam Birth Centre, Maple Ward, Rowan Ward and appointments in the community setting remain unchanged.

Lorraine Cooper said: “We will continue to monitor the effectiveness of these changes but if there is a rise in cases locally we may need to review these measures. We will continue to inform the public of any changes through all our normal channels.

“We encourage women not to cancel any appointments based on the relaxing of these restrictions.

“Thank you to everyone for being patient and understanding to support our staff to provide safe care.”