A COVID winter – from an acute perspective

ESHT chief executive Joe Chadwick-Bell gives her insight into how COVID has shaped winter pressures

In the last weeks of the November lockdown we started to see the number of community cases of Covid in Hastings creep up. Around the same time we were hearing about the new and more infectious Kent Covid variant.

The increase in cases was more of a surprise in Hastings, because Hastings had consistently been amongst the places with the lowest Covid rates – the local Community was rightly proud that this had been the case throughout the first wave and the summer.

What began as a small increase in community cases in Hastings was quickly followed by an increase in people being admitted to Conquest Hospital with serious Covid symptoms. The increase in Hastings rapidly spread westwards and we saw increasing cases in our community hospitals and at Eastbourne DGH.

During December we saw an eight-fold increase in the number of Covid positive inpatients in the Trust. At the height of the second wave we had over five times the number of Covid positive inpatients when compared to the height of the first wave. By early January nearly 60% of our beds were being used to care for patients with Covid.

When we saw the first signs of the increased cases in Hastings and the new variant, our incident management system kicked back in and we started to prepare for the inevitable increase in hospital cases. Our priority is always to care for those most in need and to keep patients and our staff safe. That’s very easily said, but in reality it meant some very challenging decisions for us.

We made the very difficult decision to reschedule routine planned surgery – to allow us to focus on clinically urgent elective cases, caring for Covid-19 patients, emergency care, cancer care and diagnostics. One of the things that we learnt from the first wave was to maintain our diagnostic work as much as we could. We also temporarily suspended home births and births at our midwife led unit in Eastbourne. The midwifery team worked hard to make sure that anyone who was moved to Conquest got an experience as close as possible to the one they were expecting at home or at our midwife-led unit.

The first thing that people think of when they picture our Trust are our front line staff. And it’s absolutely right that our clinicians and healthcare staff working in critical care teams, our Emergency Department Teams, in our wards, services and in the community are recognised for the amazing dedication that they have shown. But in reality without our support functions, notably our Digital team, our Estates team and our HR team they wouldn’t have been able to get on with their job of providing care through the challenging winter months.

Our Estates and Facilities team moved mountains to reconfigure our hospitals and services, increasing bed capacity by converting surgical wards into medical wards, creating additional critical care facilities and even creating new wards – Devonshire Ward and Firwood Ward. Without their work to rapidly upgrade our Oxygen facilities at both acute hospitals we wouldn’t have been able to cope with the numbers that we saw needing Oxygen. Working with our pathology team and healthcare scientists they created space for a new Covid testing facility which was an important turning point for the Trust.

Our Digital team helped people who didn’t need to be in the hospitals work effectively from home. They also supported our drive to see more patients by telephone or virtually and made sure that when Wards and services were being moved, they had the right technology to provide care.

Our HR team increased recruitment both temporary and permanent and invited people who had left the NHS to come back and take on important roles. They encouraged members of staff with previous clinical experience to put on their uniforms again and supported non clinical members of staff who volunteered to be redeployed to help support core patient services.

My point is that getting through the last three months, indeed the last 12 months, has been a joint effort from our amazing and dedicated 7000 plus community and hospital teams, working alongside our system partners across Sussex and social services and other healthcare services in East Sussex. I cannot put into words how proud I am to work as part of this team. We are also so appreciative for the tremendous support we have had from our local community – a wide range of donations to support our staff, along with people offering their time to volunteer and support our teams.

We are not out of the woods yet, but we have started to turn a corner. Over the last few weeks, we have started to see Covid numbers reduce as the effect of lockdown and the vaccination programme take effect. We have started to close some of the additional beds that we opened and are gradually returning some services (like home births and our Eastbourne Midwife Unit). From the 1 March we will be restarting our elective programme and will gradually increase capacity as the pressure on our critical care services reduces, while making sure that we offer the right physical and physiological support and space to give our staff a chance to come to terms with what they’ve been through – and take some well-earned leave!