The taskforce carefully considered an extensive range of issues in relation to the social care sector as a whole, brought together as key themes. These included the provision of personal protective equipment, COVID-19 testing arrangements, the winter flu vaccination programme, infection prevention and control, and issues of funding. The taskforce examined a number of issues relating to the workforce and family carers (unpaid), including how best to restrict the movement of people between care and health settings. Among other themes, the taskforce reviewed the role of clinical support within the sector, the availability and application of insights from data, and implications of inspection and regulation.
This report sets out the action that will need be taken to reduce the risk of transmission of COVID-19 in the sector, both for those who rely on care and support, and the social care workforce. This report sets out how we can enable people to live as safely as possible while maintaining contacts and activity that enhance the health and wellbeing of service users and family carers.
Throughout this report, a number of recommendations are made based on learning from the first phase of the pandemic. They range from 'quick wins' to consideration of topics that will require a degree of more substantial change and/or additional resource. In addition, there are a number of supporting recommendations in the annexed reports of the subject-specific advisory groups, which should be considered in tandem with the main report recommendations.
The free version of Hospify is available right now and is in daily use at over 150 clinical sites around the country including London North West University Healthcare Trust, County Durham and Darlington, University Hospitals North Midlands, Frimley Park and Lincolnshire Community NHS Trust. Hospify is also backed by Innovate UK, Wayra Velocity Health (in partnership with Telefonica and MSD Pharmaceutical), Kent Surrey Sussex AHSN and the UNISON and Managers in Partnership Unions.
A premium version of Hospify specifically designed for healthcare teams is also now available. Called the Hospify Hub, it features an online admin portal for onboarding staff, a web app that syncs with users’ phones, broadcast messaging/paging with document attachments and a survey and data collection tool.
Please email email@example.com for more details or visit hub.hospify.com to set up a Hub and give it a try for yourself.
This guidance is produced during the COVID-19 outbreak in order to support the care in the community of patients and those important to them, at the end of their lives or who are unwell as the result of COVID-19 or other life-limiting illnesses.
This document will be updated and adapted as further contributions are received and in line with changing national guidance. The most current version of the guidance document will be available on the public-facing pages of the RCGP COVID-19 Resource Hub and Association for Palliative Medicine website.
Please check that you are referring to the most current version.
Eastern AHSN provided Quality Improvement (QI) coaching to the nurses employed by South Norfolk Clinical Commissioning Group (CCG) to work with residential and nursing homes across central Norfolk and Waveney to support the implementation of the checklist approach.
The overarching aim was to reduce avoidable admissions to hospital from care homes. The Eastern AHSN believes this successful project is an easily replicable approach to the improved management or prevention of UTI and can directly impact by not only improving patient care with the added benefit of admission avoidance and reducing unnecessary clinical call outs.
Successful results and benefits:
At the time of writing, 700 staff from 104 care homes across Norfolk have been trained in the management and prevention of UTI and how to complete the UTI checklist. Unplanned emergency admissions have reduced by 22% and a reduction in antibiotic prescribing has been seen within this cohort of care homes.
Staff reported increased confidence in the management and prevention of UTI.
Data from the checklists highlighted that a lot of UTIs were related to catheter management and obtaining samples from the bag, which became increasingly preventable from the change in treatment.
Care workers were assuming residents had an UTI, but after the teaching sessions they realised it may be dehydration that could present the same symptoms and commenced re-hydration.
If an UTI is suspected then the staff were taught to initially think dehydration and to increase fluid intake then to reassess the patient prior to making call outs.
Care homes are not now doing routine urine dipsticks or using urine dipsticks as a diagnostic test to diagnose UTI’s which has improved our diagnosis of UTI.
Feedback from care homes and primary care has been very positive with one care home manager emailing to say: “The UTI checklist is definitely used at our nursing home and we have noticed a positive difference since we started. Thank you for your support.”
The AHSN North East and North Cumbria (AHSN NENC) Well Connected Care Homes Programme commissioned a small-scale evaluation of a new digital health intervention that aims to enhance the appropriateness of healthcare received by care home residents and the skills of care home staff.
The goals were to:
support care homes in becoming internally and externally ‘well connected’ in the digital age;
to enhance the quality of care experienced by care home residents, and by
significantly improving communication between care homes and the external health environment.
This would provide better and more efficient cost-effective care. It had the following elements:
to improve record keeping of care home residents by using tablet-based apps to allow electronic recording of aspects of care plans
to train qualified and unqualified care home staff to make and record relevant clinical records (NEWS scores)
to promote use of electronic communication of patient clinical information between care homes and primary care (GP electronic patient records), emergency care (including out of hours), and ambulance services and community services.
UTI hospital admissions reduced by 36% in the four pilot care homes (150 residents).
UTIs requiring antibiotics reduced by 58%.
The gap between UTIs increased from an average of nine days in the baseline period to 80 days in the implementation and sustainability phase.
One residential home was UTI-free for 243 consecutive days.
Similar outcomes noted in pilot 2 care homes (215 residents).
What will I learn?
Basic personal alarms for the elderly.
Alarms that send a signal for assistance.
Personal alarms and telecare.
Fall detectors and alarms.
How much does a personal alarm cost?
Lifeline alarm services.
Choosing and buying a personal alarm.
How to use the tool
The tool can be used prospectively or retrospectively to assess products, their features, and how those could impact on their safe use. This will help determine whether any patient safety issues could arise in relation to a specific medicine. It can also be used as part of the learning process if any product-related incidents have arisen in a pharmacy. The form should be completed by a pharmacy professional and any findings, particularly where the boxes next to text marked in red have been checked, should be shared with team members and the Superintendent Pharmacist if necessary.
The findings demonstrate some significant positive improvements since 2016, such as the increase in the proportion of respondents who receive helpful feedback and learning as a result of reporting incidents. From the feedback given by survey participants, the following key improvements will help enable the community pharmacy sector to continue improving incident reporting levels and the culture in pharmacies:
simpler reporting tools
training for pharmacy staff on incident reporting
ensuring that all pharmacy staff receive feedback and learning they find helpful
fostering an open culture of sharing and learning.