Hospital bosses has managed to see almost half of its patients awaiting outpatient appointments despite the impact of COVID-19 on the NHS.

Hull University Teaching Hospitals NHS Trust had to cancel services including non-urgent appointments and routine operations in line with hospitals around the country in response to COVID-19.

At a meeting of the trust board today, board members heard around 50 per cent of outpatient appointments have still gone ahead, with almost two-thirds of follow-up appointments taking place. All urgent cancer treatment has still gone ahead.

However, there are now 85 patients waiting more than 52 weeks for treatment, with 83 of those reported in March alone when the cancellations were introduced.

The ‘thank you NHS’ message at the entrance to Argyle Street car park

Chief Operating Officer Teresa Cope told the board: “The impact of COVID-19 has been significant.

“On March 11, the trust moved into Incident Command status to respond to the Covid-19 Pandemic. This required the trust, in accordance with national guidance, to take a number of actions to prepare for receiving high volumes of patients with suspected and confirmed coronavirus.

“This included ceasing all routine out-patient, diagnostic and elective activity. In addition, other restrictions were placed on other activity and diagnostics tests which are Aerosol Generating Procedures (AGPs).”

Only 80 per cent of patients could be scanned or scoped within the target of six weeks during March and national guidance, which required endoscopy and CT colonoscopy work to cease for all patients except emergencies, will continue to mean increased numbers of patients waiting for diagnostics tests.

Fewer people have been referred to hospital for urgent tests and appointments by their GPs since the ‘lock down’ measures were introduced by the Government on March 23.

However, there were positives.

In February, the two-week target for people undergoing tests for cancer was achieved and 92 per cent of women referred for breast cancer investigations were seen within a fortnight against a 93 per cent target.

ED performance was 89 per cent last month, just short of the target of seeing 95 per cent of patients within four hours, mainly due to the decrease in the number of people coming to the department.

No patient had to wait on a trolley for 12 hours or longer for the whole of 2019/20.

Mrs Cope praised the “exceptional work” undertaken by staff in health groups who are introducing innovative measures such as video and telephone clinics to ensure patients can still be seen as safely as possible.

Nurses Day celebrations take place every year on 12^th May, but in 2020, there’s even more reason than usual to celebrate the contribution nurses make in our society.

Hull University Teaching Hospitals NHS Trust’s nursing staff have been central to the hospitals’ COVID-19 response in recent weeks, working round-the-clock in areas such as intensive care, emergency care and infection control to provide the best care possible for patients.

But nursing staff can be found in all areas of Castle Hill Hospital and Hull Royal Infirmary, as well as community clinics too. The Trust employs research nurses, children’s nurses, and nurse specialists who are experts in a particular illness or condition such as diabetes, stroke or heart failure. Then there are respiratory nurses, nurses who manage organ donation, and advanced nurse practitioners, who undergo extra training to work at a higher clinical level.

In total, the Trust employs more than 2,600 registered nurses and almost 1,200 healthcare assistants, without whom the organisation would be lost.

Beverley Geary, Chief Nurse for Hull University Teaching Hospitals NHS Trust says:

“Nurses Day is always a great opportunity for us to pause, reflect and really appreciate the contribution our nurses make to our organisation.

“With the arrival of the COVID-19, it’s no longer just ourselves who are truly seeing the value of our nursing staff. We’ve received so many donations and offers of support in recent weeks for them, and now with the weekly Clap for Carers, our communities are also showing a renewed understanding and appreciation for all that they do.

“It can be physically and emotionally challenging at times, but a career in nursing is so rewarding and provides so many different opportunities to progress and to specialise.

“I’m proud to be a nurse and would like to take this opportunity to say thank you to all our nursing staff for their care, compassion and dedication, not just now, but every single day of the year.”

The bespoke design for Hull nurses by Helena Mackevych

One of the kind gestures shown to the trust has come from Sheffield-based Helena Mackevych. Illustrator Helena has designed and donated a stunning piece of artwork which thanks all nurses and midwives at the Trust. Two prints of Helena’s work will be framed and displayed around the hospitals.

Helena says:

“I wanted to create this because I’m so grateful to everyone in the NHS for everything they do all the time, and even more so at the moment. They are taking such risks to take care of us all; such amazing and courageous people.”

Beverley adds:

“Helena’s design is just stunning, and will serve not only as a lasting reminder of the current situation, but as an ongoing thank you and show of appreciation for the work of our nurses and midwives.

“We’d really like to thank Helena for donating her time and her effort, the illustration really is beautiful.”

Some operations and outpatient clinics at Hull Royal infirmary and Castle Hill Hospital will resume next month as hospital bosses prepare for the next stage of the COVID-19 pandemic.

Hull University Teaching Hospitals NHS Trust (HUTH) will reintroduce some non-urgent surgical procedures, investigations requested by GPs and outpatient clinics as part of its plans for the second phase of the outbreak.

Patients with suspected or confirmed cases of COVID-19 will be cared for in three designated wards at Hull Royal Infirmary to allow other wards to restart normal activities.

Retrained clinicians will continue to cover long-term absences, such as staff with underlying health conditions who are required to shield until at least the end of June.

Chief Operating Officer Teresa Cope, who is leading HUTH’s response to COVID-19, said: “We apologise to every patient whose treatment has been on hold while we deal with the pandemic and we thank them sincerely for their understanding.

“We won’t sugar-coat the situation or pretend this is not serious. We know many of our patients have waited – and will continue to wait – far too long. We are so sorry about that.

“But we are doing everything we can to restart services as soon as possible while ensuring we are not overwhelmed by the pandemic.”

Although urgent and emergency surgery, as well as cancer treatment, continued, outpatient appointments and non-urgent operations were cancelled by hospitals all over the country in March to protect the NHS and create enough intensive care capacity for those with the most severe form of the virus.

Almost 90 patients with suspected or confirmed COVID-19 are still receiving treatment at the hospital and 119 have died since March 19. Around 280 people have been well enough to go home.

As part of HUTH’s second phase planning, COVID-19 bed numbers have been scaled back from more than 200 to 170. The long-term plan to have all patients with suspected or confirmed cases of the virus at Hull Royal Infirmary unless their clinical teams decide they should be elsewhere.

Some non-urgent surgical procedures and treatment will be reintroduced over the coming weeks and telephone and video clinics will continue wherever possible to prevent people making unnecessary trips to hospitals. People considered a higher clinical priority will be called in and tested for COVID-19 before their procedure goes ahead in line with the trust’s policy to test all patients on admission or before surgery.

In line with national guidance, visitors will only be allowed onto wards in exceptional circumstances, such as to be with a loved one at the end of their lives, to protect staff and patients from the infection.

Services will only be introduced when there is enough personal protective equipment (PPE) to keep staff and patients safe from the risk of infection.

Teresa Cope said  “We coped really well with the surge in admissions, which wasn’t as severe as the national modelling originally predicted because people listened to the advice and stayed at home.

“This is far from over. We still have around 90 patients with COVID-19 on our wards, with new admissions every day, and we expect it to remain like this for most, if not all, of this year.

“People are aware of the global demand for PPE. The safety of our staff and patients remain a priority for us and we will only reintroduce services when we are confident of keeping everyone safe.”

Over the coming weeks, people waiting for treatment will be notified by the trust’s administrative team if their appointments have been rescheduled. Please do not contact the trust directly to find out if your treatment is to be rescheduled as this will only add to the pressure on the organisation.

Hospital managers in Hull are inviting the public to join them in their first ever online meeting.

The Board of Hull University Teaching Hospitals NHS Trust will be trialing the use of video and telephone conferencing facilities for its May Trust Board meeting next week.

Carla Ramsay, director of corporate affairs

Carla Ramsay, Director of Corporate Affairs for the Trust, says:

“In light of the current coronavirus pandemic, levels of interest in hospital activity and how we’re responding to the situation are understandably high.

“We normally hold our Board meetings in person, however it’s essential for us to uphold social distancing rules and ensure members of the public do not attend our hospital sites or put themselves at risk unnecessarily.

“To this end, we have decided to use video and telephone conferencing facilities for the first time to enable members of the public to attend the meeting in a safe and convenient way.”

Guests will be able to watch the Board discussion on topics such as staffing, performance, and of course, pandemic preparations. And as would normally be the case, members of the public will also be able to put questions forward for a response at the end of the session.

Carla adds:

“The use of video conferencing within the trust has rocketed since the lockdown began, but we’re finding it a particularly good way of keeping in contact and, in this case, still ensuring openness and transparency at a time when people can’t physically join us.

“If the trial proves successful and uptake is good, this is something we would certainly look to continue at our Board meetings to enable more staff and members of the public to attend in the future.”

The May Trust Board Meeting will take place between 10 and 11:30am on Tuesday 12^th May. The agenda can be found on the trust website: www.hey.nhs.uk/about-us/trust-board-meetings/

If you would like to attend, please email rebecca.thompson71@nhs.net to request the joining details. Questions for the Board can also be submitted in advance using the same email address*.

Note

* Questions will not be answered directly on an individual basis, instead discussion will take place and responses to each question will be summarised in the minutes of the meeting.

They are united by a purpose to keep hospital staff as safe as possible during the COVID-19 pandemic.

For two months, the Supplies team at Hull University Teaching Hospitals NHS Trust (HUTH) have battled against global shortages to ensure ward staff have enough personal protective equipment (PPE).

Thanks to the team led by Head of Procurement Julie Lumb, every ward and department has enough PPE to keep their staff and patients safe.

Chief Nurse Information Officer Steve Jessop said: “I wouldn’t be able to sleep at night if we didn’t have enough PPE for our staff but, thanks to Julie and her team, we’ve never had that problem.

“Just like every other large teaching hospital, we’ve had problems sourcing PPE but the team have found solutions to every one of those issues, coming up with alternatives and never giving up.

”We owe them huge thanks for the supreme effort they make every single day to keep our staff as safe as possible.”

Some staff from the Supplies team

Hull Royal Infirmary and Castle Hill Hospital have used millions of items of PPE since the trust confirmed the country’s first two cases of COVID-19 at the end of January.

Each week, Hull Royal Infirmary and Castle Hill Hospital uses

• 403,600 pairs of gloves
• 67,500 surgical masks
• 164,600 plastic aprons
• 7,180 FFP3 masks for high-risk procedures
• 10,870 coveralls
• 2,050 sterile surgical gowns
• 4,720 visors
• 26,500 orange waste bags
• 750 bags for contaminated waste
• 900 surgical hoods
• 96 boxes of disinfectant
• 624 bottles of alcohol hand rub
• 555 bottles of hand rub
• 540 bottles of hand wash

In the first weeks as countries scrambled for PPE, the trust used local manufacturers and suppliers outside its normal supply chain.

Businesses including ARCO, Siemens, Howden’s and organisations such as the University of Hull and Humber Fire and Rescue and local schools helped by supplying the trust with everything from visors to scrubs and goggles. Hull tailor Cock of the North supplied the trust with almost 1,000 reusable gowns and hundreds of pairs of scrubs have been donated,

Stocktakes are undertaken every day, with emergency supplies held at both hospitals to ensure no ward, team or department ever runs out. Daily reports on stock levels are sent to the tactical response group set up by the trust to tackle the outbreak so any shortages are prioritised.

Mr Jessop said: “We are trying, wherever possible, to source reusable items and we are very grateful to firms and organisations in East Yorkshire which have stepped forward with offers of help.

“When there has been a national shortage of one item, such as the recent gowns, the team had already sourced coveralls as an alternative before it was suggested at a national level.

“They’ve found us masks which surpass the required standard, making our staff among the safest in the country.

“Although certain brands or types of PPE have run out, we’ve always had an acceptable alternative for staff thanks to the efforts of Supplies.”

People will be turned away from Hull Royal Infirmary this week if they show up at A&E with minor injuries and illnesses to protect services for the COVID-19 pandemic.

Hull University Teaching Hospitals NHS Trust is once again seeing an increase in people turning up at its Emergency Department when they could go elsewhere.

While attendances fell to under 200 at the start of the lockdown, attendances climbed to 290 again last week.

Chief Operating Officer Teresa Cope said: “We have had a long-standing problem with people using Hull Royal’s Emergency Department for minor health complaints which are not serious, let alone an emergency or life-threatening.

“Now, more than ever, we need people to use alternatives like the Urgent Treatment Centres, pharmacies and the GP walk-in service at Wilberforce Health Centre so our limited resources and staff are used for the people who need us most, such as those with breathing difficulties caused by the virus, and those having heart attacks and strokes.

“We appreciate the amazing support people are showing the NHS but the best way to help us is to only come to A&E with genuine emergencies.

“If you help us spread the word and make sure all your family and friends do the same, we’ll have a better chance of coping with the outbreak.”

In the past fortnight, frontline staff have been asked to see people with skin complaints like verrucas, minor sprains and long-standing complaints which would be treated best by a GP, pharmacist or Urgent Treatment Centre.

This week, anyone who comes to Hull Royal will be triaged by a senior nurse before they are allowed into the Emergency Department. Anyone coming to the hospital with a problem which is not a genuine emergency will be diverted to another service in the city.

Mrs Cope said: “Most people know if their problem is a serious or not yet many still choose to come to our Emergency Department. We don’t know if that’s because they think they’ll be seen more quickly or by a more experienced practitioner but neither is true.

“You’re likely to be seen far more quickly if you go elsewhere and the staff at Urgent Treatment Centres or the walk-in centres are highly experienced.

“If you come to here with a minor illness or injury, you will have a wasted journey as we do not have the resources or time to spend with anything which is not a genuine emergency.”

If you need urgent medical help, use the NHS 111 online service. If you cannot get online, call 111. UTCs can treat minor ailments such as cuts, burns and suspected fractures, with no appointment necessary. Find out more about East Riding UTCs here and Hull UTCs here.

Staff retrain, redeploy and reorganise to ensure patient care remains top priority during the COVID-19 pandemic

For the hundreds of NHS workers involved in hospital outpatient services in East Yorkshire, the past few weeks have been anything but ‘business as usual’.

As the scale of the effort required to respond to the coronavirus pandemic became clear in March, Hull University Teaching Hospitals NHS Trust had to act quickly to protect its patients and prepare its staff and services.

This was no more acutely felt that in outpatient services, where thousands of routine appointments have been cancelled as far afield as Pocklington, Bridlington and Hornsea.

Eileen Henderson Head of Outpatient Services for the trust explains:

“As the COVID-19 situation began to unfold, we knew there was going to be a need to work differently.

“Encompassing over 30 different specialties* and collectively running over 1,000 clinics each week, the scale of the challenge for outpatients was huge.

“We needed to cancel thousands of appointments for our patients, to release and retrain many of our staff to help in more business critical parts of the hospitals, while still maintaining some level of business continuity in each service for those patients whose care simply cannot wait. We also needed to ensure those key services which the trust has committed to maintaining, such as cancer and cardiology, remain staffed and equipped to continue with their potentially life-saving work.

Aimee Fenn (left) and Katie Kavanagh of the Plastics Trauma outpatients team

“Each of the outpatient areas works slightly differently to best meet the need of their patients, so their responses to the pandemic have also varied in nature. Some teams, such as Plastics, have turned to video consultations as a means of conducting urgent appointments, for example, while others such as Vascular Outpatients have combined some of their physical clinics to create a one-stop-shop, meaning patients who do have to come in can see several experts at once and so reduce the number of hospital visits they have to make.

“But what has really impressed me has been the way staff have really wanted to roll their sleeves up, to join their colleagues and support the COVID-19 response in any way they can.”

Staff have flexed to deliver services in different places in order to protect patients at higher risk. Certain patients can now have their bloods taken in the Brocklehurst Building, for example, or attend clinics in the diabetic eye screening department to avoid the need to visit highly populated areas of the Hull Royal Infirmary site, thereby reducing their potential risk of exposure to COVID-19.

Both clinical and admin staff have also undertaken additional training to be able to support in areas with greater need or staff shortfalls.

“Redeployment of staff is a key part of our major incident planning, and with far fewer outpatient clinics running at the moment, staff have been asked to undergo training to be able to help out in parts of the hospital which are normally unfamiliar to them,” Eileen continues.

“Without exception, outpatient staff have embraced the challenge and approached this with such positivity, from the healthcare assistants and nurses right through to the admin staff and the doctors.

Healthcare assistants Jayne Hay (left) and Suzanne Dixon

“We’ve had staff who have worked in outpatients for years relishing the challenge of going back into a ward environment, and healthcare assistants stepping up to further enhance services in other parts of the hospital. I’ve been so impressed with just how keen and supportive our outpatient teams have been when it comes to working across different areas and supporting the patients who still need our care.”

Jayne Hay is one of those healthcare assistants who has moved from her usual role in the medical outpatient team to support the phlebotomy service at HRI. Not only does it mean Jayne and her colleagues Linda Bell and Suzanne Dixon have been able to provide an additional afternoon bloods round service to the wards, but this has also freed ward nursing and medical staff up to focus on more direct patient care.

Jayne says:

“We take lots of bloods normally in an outpatient setting, but acknowledge it is harder to take bloods from patients in a hospital bed. My move to phlebotomy in support of the coronavirus response has certainly opened my eyes, and I have a new respect for the staff working in a ward environment. ”

Eileen adds:

“We know how inconvenient it can be for someone to have their appointment cancelled and we know people worry about their health, so clinic cancellations are never something we would want to do. However the situation we find ourselves in is unprecedented, and we hope people see just how hard we have been working to support them through the outpatients service and in other parts of the hospital as well.

“I’d like to thank patients who have been affected by outpatient cancellations for their patience and understanding at this time, and of course I’d like to praise the outpatient service staff for their willingness to step up and join the battle against COVID-19.”

*Outpatient services encompass more than 30 different specialties including antenatal care, diabetes, neurology, ophthalmology, cardiology, oncology and gastroenterology. Collectively the trust’s outpatient service would deliver in the region of over 1,000 clinics every week at multiple sites across Hull and East Yorkshire including hospitals and health centres.

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Covid -19 patients involved in a clinical trial of the drug Remdesivir at Hull University Teaching Hospitals NHS Trust are recovering faster than expected. This supports the results of a trial conducted in healthcare organisations around the world on behalf of the National Institute of Allergy and Infectious Diseases (NIAD) which showed  patients who received Remdesivir recovered a third faster than those on a placebo.

The drug has yet to be approved and there is more work to do, but the early indications are that the drug is safe and effective.

The drug itself has been developed over the last decade by therapeutics company, Gilead, initially in response to Ebola and has been tried in other coronaviruses such as SARS and MERS.

One of the first patients in the country to receive the drug was treated at Castle Hill Hospital and is now at home recovering. So far, ten patients have taken part in the trial which is being conducted on the infectious diseases ward.

Professor Alyn Morice, who leads the trials unit in Hull, said:

“There is a long way to go in testing this drug before it can be approved for general use but our trial certainly indicates that we have reason to be optimistic that Remdesivir is effective. In general terms, the patients we treated with the drug are recovering much faster than expected.

“I have personally just recovered from Covid-19 myself and it was extremely unpleasant, so while we are cautious about this drug anything which might help patients is very welcome news.”

Patrick Lillie, Infectious Diseases Consultant at Hull University Teaching Hospitals NHS Trust and lead clinician for the trial, said:

“We are seeing the impact that Covid-19 has on our patients every day. For those in hospital it isn’t an easy experience at all, and clearly some people are symptomatic for weeks not days. The Infectious Diseases team are really pleased to have been involved in this early trial of Remdesivir but we must stress that it is not available to use at the present time, except within a clinical trial.”

For the past six weeks, the UK has been in lockdown. During that time, hospital workers at Hull University Teaching Hospitals NHS Trust have been inundated with generous and kind offers of help and support from the public; everything from the production of PPE to donations of bread, toiletries, hot dinners, even Easter Eggs.

Now it is the turn of hospital staff to say thank you back to the public and other key workers for playing their vital role in the fight against coronavirus.

Simon Nearney, Director of Workforce and Organisational Development at Hull University Teaching Hospitals NHS Trust, said:

“We have been sincerely moved by the generosity and kindness of so many people and local businesses. The local community has also played and continues to play its part in the fight against Covid-19 and as such our staff wanted to say a massive thank you to the people of Hull and East Riding.  We want people in our region to know how much we value their efforts just as they have appreciated ours.

“In the spirit of social distancing, we’ll be sharing a special thank you message on social media today. We want to acknowledge the sacrifices people across our area are making in order to protect themselves and the NHS. We also want to show our support for our fellow key workers, such as supermarket staff, bus drivers, postal workers and care workers who also continue to put themselves at risk to serve our community.

“By staying at home, remaining distanced from loved ones and friends, socially distancing in supermarkets and observing good hand-washing practices, the public are making it possible for us to cope with a gradual rise in the number of coronavirus patients.

“It’s important to understand that this situation is not over by any means, but we are in a better position locally thanks to the measures that people have taken so far. By continuing to observe the rules we can maintain that position and ensure our recovery is more effective and sustainable.

“Thank you to everyone who has shown their support for us in recent weeks, however large or small the gesture. Let’s keep up our collective efforts, and together we will beat this.”

Hull’s most senior nurse is appealing to the public to stay at home to mark the #ClapForCarers event tomorrow night.

People have been coming to Hull Royal Infirmary on Thursday nights to take part in the national round of applause for NHS staff, carers and key workers.

However, concern is growing that people are putting themselves and others at risk by making a non-essential journey to take part and are then failing to observe the two-metre distancing rule.

Chief Nurse Beverley Geary

Now, Beverley Geary, Chief Nurse at Hull University Teaching Hospitals NHS Trust, is appealing to the public and the media not to come to the hospital tomorrow night.

She said: “Our staff are deeply moved by this amazing show of support by the public and we want to say how grateful we are to everyone taking part.

“But we’ve become increasingly concerned that people are coming to hospital just to clap and are putting themselves and others in danger by standing too close to each other. We’ve seen the numbers increase,  week by week.

“We would like to thank you for your fantastic support but stress you can help the NHS best and save lives by staying at home this week.”

The trust dealt with the first confirmed cases of COVID-19 in the UK when its Infectious Diseases team, based at Ward 7, Castle Hill Hospital, received the first two patients at the end of January.

Thanks to the national observation of the lockdown, Hull Royal Infirmary and Castle Hill Hospital have coped well with the admission of hundreds of patients suspected with or diagnosed with COVID-19.

Sadly, 88 people with the virus have died since March 19. However, more than 200, including 21 who have undergone treatment in the trust’s five Intensive Care Units, have recovered well enough to go home.

There are still around 130 patients with COVID-19 or suspected of having the virus in the hospitals.

Mrs Geary said: “If people start making non-essential journeys once again before the lockdown is lifted, there is a very real danger that we will start to see a sudden spike in cases once again which could overwhelm the NHS.

“Please stay at home on Thursday night to protect your NHS, save lives and support our staff in the best possible way.”