07 April 2020
Statements by Caroline Landon, Director General for Health and Community Services, Rob Sainsbury, Health and Community Services Group Managing Director, Patrick Armstrong, Jersey’s Medical Director, and Rose Naylor, Jersey’s Chief Nurse
Caroline Landon, Director General for Health and Community Services
I am here today to talk to you about how Jersey’s health service has prepared for COVID-19.
First, I want to start by thanking all of Jersey’s healthcare workers – across HCS and in the community – colleagues in the Hospice, Family Nursing, primary care, charitable organisations and everyone on this Island who is delivering care or supporting the delivery of care. I want to acknowledge your boundless dedication at this unprecedented time.
Thank you for your commitment.
The Island is relying on you during this emergency.
And the Island is grateful to you for what you are doing to keep everyone safe and to treat those who get sick.
Ultimately, lots of us will contract and recover from COVID-19.
But sadly, some Islanders will not recover, and it will take their lives prematurely.
This will not be for want of expert health care, but because some people will be unable to resist the most dangerous effects of the virus on their health.
And that’s why our Medical Officer of Health and our ministers are asking everyone to stay home, for people to keep their distance from each other, and for people with symptoms and their households to self-isolate.
The global health community was first made aware of COVID-19 by colleagues in China in December 2019 and it was made public early in January this year.
Around the world, countries’ healthcare systems immediately started preparing and planning for the virus reaching their shores, and Jersey did so too.
Much of what we do isn’t visible to patients or to the public.
Along with my colleagues, Rose Naylor, who is Jersey’s Chief Nurse, Patrick Armstrong, Jersey’s Medical Director, and Rob Sainsbury our Group Managing Director, I am going to share with you today some of the detail of what we have been doing behind the scenes to ensure that our health response is both timely and appropriate.
The areas I want to talk you through cover the following aspects of our emergency healthcare planning and response:
The command and control systems we’ve put in place
The capacity of the system to cope with the demands that Coronavirus will place on it
The availability of skilled healthcare professionals
The availability of equipment.
So, let me ask my colleagues to outline how we’re co-ordinating our response.
Rob Sainsbury, Health and Community Services Group Managing Director
Thank you, Caroline.
Throughout January and February, our department convened a daily Scientific, Technical and Advisory Committee – or STAC – to share information, and formulate plans and actions for Jersey’s health care response to COVID-19.
The STAC now forms part of our command structure and what we call the Bronze cell which feeds into a Silver and Gold structure. This is the recommended approach for pandemic management.
It is at the very centre of the command and control structure for how HCS is responding to COVID-19 as a system leader in health and care and is made up of clinicians, professionals and operational leads.
We will oversee all aspects of the Health and Care system response and we are focussing on the whole system of health and care on the Island. The Bronze cell covers the General Hospital, mental health, primary and community care, social care, learning disability services and also our wider partners like FNHC, Jersey Hospice, care homes and care providers at home.
Our Bronze cells focus on our system capacity in terms of beds and non-bedded capacity matched against the virus modelling, we look at infection control requirements, resources, equipment, protection measures for staff and patients.
It will also co-ordinate our workforce requirements across the system.
All of our health and care groups have developed business continuity plans taking into account guidance and local arrangements and we are in the process of stress testing them.
We’ve been reviewing our operational readiness against the many checklists that have been devised from areas that have already experienced COVID-19 pressures and so we are learning from parts of Europe, America and Asia.
We’ve put these measures in place to ensure that we can manage emerging patients’ safety issues and trends, and to ensure that we can support colleagues with emergency clinical standards and policy changes.
This includes a different model of care that brings closer working together to change the delivery of care to ensure that Islanders who need the support of these services are able to access them.
I will now hand over to my colleague Patrick Armstrong, the Medical Director, who will outline plans for capacity and care.
Patrick Armstrong, Jersey’s Medical Director
Thank you, Rob.
It has become clear from other countries' experience that the number of Coronavirus cases grows slowly over time and then escalates.
So we have needed to ensure that we have the capacity in Jersey to cope with the increased demand for care.
We have tackled this in a number of ways.
Firstly we are trying to keep demand down by flattening the wave and slowing the rate of infection through the Island.
That’s why our Public Health experts advised the Government to implement self-isolation, social distancing and ‘Stay at Home’ measures.
Secondly, we have been freeing up as much current healthcare capacity as possible and creating new capacity, so we can handle the number of cases we’re likely to face.
We’ve freed up our inpatient and critical care capacity, by cancelling all non-urgent elective activity for an initial four-week period.
We’ve been able to discharge hospital patients who are medically fit to go home, again freeing up beds.
Senior clinical colleagues are constantly reviewing all activity to ensure that those patients requiring very urgent medical interventions or investigations still get the care and treatment they need.
We’re in the process of setting up an Urgent Treatment Centre to reduce the burden on our Emergency Department.
All patients arriving at the hospital are assessed for symptoms that might suggest that they are suffering from COVID-19 and are filtered through to either hot or cold areas of the hospital as appropriate.
Staff are avoiding crossing over from ‘hot’ to ‘cold’ areas unnecessarily and where this can’t be avoided are using the appropriate Personal Protective Equipment or PPE.
These measures have been put into place to prevent transmission of the virus within the hospital.
We are looking to use additional capacity in the community, outside of the hospital, to help support a whole system approach to caring for our population during this pandemic.
We’re working closely with partners and colleagues in community services to support this.
Another important part of our preparation is ensuring that we have as many skilled healthcare professionals as possible available to us.
In addition to freeing up beds, stopping routine and non-urgent work frees up health and social care colleagues to devote their efforts to COVID-19 readiness and response.
The Government has ensured that the children of essential workers can continue to attend schools and nurseries, which helps health staff in continuing to come to work.
We continue to work closely with our primary care colleagues to work out how we can use the medical workforce across the Island with maximum effect.
This needs us to work together very differently to how we normally do.
This is a complex piece of work and I am incredibly grateful to my primary care colleagues for their patient and professionalism as I know working out some of the details has been very difficult for everyone involved but I very much hope we will have more news on this very soon.
I’ll now hand over to my colleague, the Chief Nurse, Rose Naylor. Rose will outline our plans for additional staff, staff training, wellbeing and a PPE update.
Rose Naylor, Jersey’s Chief Nurse
Thank you, Patrick.
In relation to bringing additional staff into our workforce to help, we have and will continue to recruit clinical staff.
Over the past week, we have run a successful call-out campaign to attract medical, nursing and allied health professionals who have left the professional register within the last three years.
This is in line with the national guidance from the regulatory bodies, NMC, GMC and HCPC.
Our HR team are working to get as many of them as possible back to work.
Linked to this, we’re working closely with university partners to deploy medical and nursing students where we can.
We’re following the guidance set out by the regulators and our partners and the students are receiving regular updates.
We’re running practical upskilling programmes and refresher training for clinical and patient-facing colleagues and this will continue.
This training is informed by the NHS who have been and continue to develop guidance for short education programmes.
This is to ensure a wider pool of staff can be directly involved in supporting patients with respiratory needs.
But the welfare of our staff is also important.
So we’ve created a wellbeing team who are available to provide a range of emotional wellbeing support to colleagues during this difficult time. This team support staff in a range of ways, including giving staff practical support, mindfulness, and have undertaken 400 individual wellbeing checks to date.
In relation to the guidance around increased risk relating to health conditions that applies to our staff too and we’ve also made adjustments for colleagues, in line with Government guidance.
This is to enable colleagues to stay well and be supported in work wherever possible.
We’ve made provisions for colleagues who may need alternative working arrangements so that they can continue to contribute to the delivery of care from home and in alternative working environments.
And we’re working with Jersey Hospitality Association to provide accommodation for colleagues who are required to self-isolate and who are unable to do so within their own home environment.
I want to move on to talk about the availability of equipment, and especially to address concerns about personal protective equipmen, known as PPE.
It is important that we protect our staff in line with the Public Health guidance. This remains an absolute priority for us.
We’re working closely with the NHS to ensure that we maintain an adequate supply of PPE and we have received a number of very significant deliveries of PPE over the past week.
But because of the global demand for PPE equipment, we have to manage supplies of PPE carefully.
We’re reminding healthcare colleagues daily about guidelines covering the correct use of PPE – both to ensure that staff are protected, and to prevent it being wasted.
Over the weekend, we also confirmed that Health and Community Services will work with the wider healthcare agencies to safely and properly coordinate an Island-wide approach to PPE.
In practice, this means that PPE will be distributed, based on advice by medical professionals.
All organisations will designate managers who are authorised to request PPE from the PPE co-ordinating cell.
This is to work together in partnership and to ensure collectively we manage this resource in the most efficient and effective way.
Another issue of worldwide concern is the availability of respiratory equipment.
Emerging UK and international COVID-19 data suggests that a significant proportion of patients who are hospitalised need respiratory support.
We have sought to strengthen our position regarding oxygen supply and I am pleased to report that we are in a much-improved position regarding oxygen resilience.
Our goal is to have sufficient oxygen to support the needs of patients on all wards, critical care, theatres and recovery areas.
We’re also expecting fulfilment of our orders through the NHS Supply Chain for additional medical devices, such as ventilators.
Finally I would like to take this opportunity thank Islanders for their generosity and support. We have been truly overwhelmed by so many acts of kindness. We are very grateful to everyone for thinking of us.
And I can’t let this moment pass without mention of the clapping on Thursday evenings. I have been in the General Hospital the last couple of weeks and, like many of my colleagues, have been very touched by the visible and audible support from people all over the Island. It is really appreciated by everyone who is supporting Islanders at this time, we heard you, thank you, it means a lot. We couldn’t do it without you.
I would now like to hand back to Caroline to close our update before inviting questions from the media.
Caroline Landon, Director General for Health and Community Services
Thank you, team.
The world’s health services have never faced a global health challenge like this.
But I hope you are reassured that we are doing everything possible to ensure that Jersey’s healthcare system is able to respond to the Coronavirus pandemic.
And that we are as ready, prepared and resilient as we can be for when we hit the peak of the infection curve.
Again, I want to thank Jersey’s healthcare workers for all you are doing to keep Islanders safe.
And to Islanders, I cannot stress enough that in staying home, you are saving lives.
I know that it is difficult, and it goes against human nature to isolate yourselves, but this is the only way to protect ourselves, our families, friends, colleagues, neighbours and strangers against this virus.
Thank you to my fantastic colleagues in Health and Community Services and in healthcare across the Island, who come to work to save your lives: so stay at home to save theirs.
I would now like to invite the media to ask any questions you may have.