Today’s cabinet update is below, the next meeting is on Weds 3rd June
- PPE usage
- Antibody testing
- Changes to staff testing
- Patient testing
- Employment services update
- NHS Covid Heroes
PPE
The Trust is reviewing risk assessments for all staff groups on an on-going basis in relation to their medical condition and other risk factors. This may result in staff being advised to wear different types of PPE to their colleagues working in the same area or doing the same procedure(s). If there are any concerns about PPE usage please do not personally challenge colleagues. Instead, raise these with your line manager.
Antibody Testing
The trust will soon be implementing COVID antibody testing for staff.
All infection prevention and control measures will remain in place irrespective of the presence of antibodies.
Further details will be communicated in due course.
Changes to staff testing
From today (1st June 2020) all symptomatic staff and household contacts will be tested at the Regional Test Centre (RTC).
The new process is as follows:
- Complete self-isolation form and send to self.isolation@sthk.nhs.uk as per current process.
- A member of the Trust’s self-isolation team will contact the staff member via telephone to check symptoms and all contact details are correct
- Self-isolation team upload all referrals received on the day to the RTC by 15:00. Referrals received after this time will be sent the following day as per government guidance
- The staff member will receive a text message this will include a link and a verification code to allow them to book their test
- Once booked the self-isolation team will receive an email from the RTC confirming the booking. They will share this with the staff member’s manager
- If staff members do not go ahead and book their test the self-isolation team will receive an email to inform them that the process has ceased. They will share this with the staff member’s manager who will contact the individual direct
- 48 hours after the test has been completed the self-isolation team will contact the member of staff for their result
- An email will be sent to the manager informing them of the result and relevant advice given to the staff member
Which patients should be tested for COVID-19?
EMERGENCY ADMISSIONS
Testing of asymptomatic patients for COVID-19:
All patients requiring inpatient admission (i.e. at least admission overnight) require testing for COVID-19 regardless of symptoms or clinical features of COVID-19.
Therefore, even if the patient does not fulfil the case definition, send samples for COVID-19 testing, in addition to usual investigations appropriate to the patient’s clinical condition.
The test must be carried out without delay at the point where the decision to admit is made.
For asymptomatic patients, a COVID-19 test can be requested on Medway (under test name COVID-19 Novel Coronavirus PCR and on the ‘Test required’ drop down, select ‘Asymptomatic admission screen’).
Patients who are tested on admission but do not have clinical features of COVID-19 DO NOT NEED isolation in side rooms (unless they also have another reason to require this e.g. another infectious disease requiring isolation precautions or infection alert such as MRSA/VRE/CPE).
Patients with symptoms/signs of COVID-19:
The case definition(updated regularly) now includes any patient requiring admission to hospital with clinical/radiological evidence of pneumonia, acute respiratory distress syndrome, influenza like illness or anosmia (a loss of, or change in, normal sense of taste or smell) or if they develop these after admission.
If a patient fulfils criteria for a possible case, do the following immediately:
- Isolate patient in a single room with respiratory precautions (if no side room is available, patient can be cared for in a bay).
- Minimise number of staff entering the room.
- Wear the appropriate PPE: Click here to see a summary of PPE to be worn (password STHKcovid19)
- Send samples for testing, in addition to usual investigations appropriate to the patient’s clinical condition, as per GOV.UK guidance. COVID-19 test can be requested on Medway (under the test name COVID-19 Novel Coronavirus PCR and on the ‘Test required’ drop down, select ‘SYMPTOMATIC patient test’.
Repeat testing of patients who have a negative admission screen:
For those admitted from 18 May 2020, patients who test negative on their admission screen, a single re-test should be conducted 5-7 days after admission. Using the appropriate drop down selection on Medway (see below). Patients who are awaiting this repeat test result but who do not have clinical features of COVID-19 DO NOT NEED isolation in side rooms (unless they also have another reason to require this e.g. another infectious disease requiring isolation precautions or infection alert such as MRSA/VRE/CPE).
Elective admissions (including Day Surgery admissions)
Please see admission pathway for further details (note patients for urgent elective cancer surgery should follow locally agreed process). In brief – Patients should isolate for 14 days prior to admission along with members of their household and undergo a pre-admission COVID-19 test (conducted a maximum of 72 hours in advance).
Other elective day attendances for interventions
Please see relevant pathway for further details. In brief – these patients do not need to self-isolate for 14 days prior to the attendance but will need a pre-admission COVID-19 test (conducted a maximum of 72 hours in advance) if they are attending for an aerosol generating procedure or a procedure where the clinician has prolonged close contact with the patient (within 2 metres for more than 1 hour).
Discharges
All patients being discharged to a care home, hospice and, in some situations, when a patient is being discharged with a package of care (essentially if the care providers request it) should be tested up to 48 hours prior to discharge. Please see the discharge pathways for further details.
How to request COVID-19 tests
These can be requested on Medway under COVID-19 Novel Coronavirus PCR. Note: there is no longer a requirement to fill in the additional E28 form.
There is a drop down box to select the test required as shown below:
| Indication | Medway drop down option | Rapid test |
| Any patient (new admission or existing inpatient) with clinical features of COVID-19 | SYMPTOMATIC patient test | No |
| An emergency admission screen for COVID-19 on any patient who requires at least overnight admission to the Trust who has no clinical features of COVID-19 | Use Asymptomatic admission screen | No |
| Requesting a repeat screen on any inpatient 5-7 days after admission whose original admission screen was negative | SYMPTOMATIC patient test or Asymptomatic admission screen as appropriate according to clinical condition | No |
| For testing patients prior to discharge to care home or other healthcare setting when indicated | Clearance swab | No |
| For testing previously COVID-19 positive severely immunocompromised inpatients or inpatients who have received ICU care during the current admission prior to stepping down infection prevention precautions | Clearance swab | No |
| For testing patients other than those being admitted electively for urgent cancer surgery and those who are in the shielded/extremely vulnerable category for screening at pre-op 48-72h in advance of their elective admission for surgery/other procedure | Elective pre-op NON-urgent | No |
| For testing patients prior to urgent elective cancer surgery OR extremely vulnerable patients under shielding who attend for elective surgery/procedures on the day of admission | Elective pre-op URGENT | Yes |
Please Note: current availability of rapid tests is strictly limited (approximately 20 in total per day) hence these MUST only be used as stated above. Any exceptions MUST be discussed with a Medical Microbiologist on a case by case basis before the test is requested.
Guidance related to COVID-19 is updated regularly, always refer to the most up to date version of the guidance online at https://covid.sthk.nhs.uk/
Employment Services update
Updates have been added to the Employment Services page on the Covid website: https://covid.sthk.nhs.uk/employment-services-payroll/ (password: STHKcovid19) in relation to some of the changes that impact on employee pay relating to COVID-19 as below:
- Pay for COVID-19 Redeployment – enhancements to be paid in June 2020 pay
- Reminder to keep your personal and pension details up to date on ESR
- Support for retired members of the NHS Pension Scheme who have returned to work
- Be aware of scam tax avoidance schemes targeting workers returning to the NHS
NHS Covid Heroes
Today we say a big thank you and well done to our fantastic Medical Registrars.
Throughout the pandemic they have pulled together and shown great leadership; planning, implementing and managing their rota to support the Trust’s response, between them caring for almost every patient that has been admitted with COVID-19.
It’s been a physically and emotionally challenging time but their positive and practical approach has been hugely appreciated by colleagues across the Trust. Well done to you all!
