To receive an update from the Royal Berkshire NHS Foundation Trust on how it has been working with the Council during the Covid 19 pandemic.
Dom Hardy, Chief Operating Officer, Royal Berkshire NHS Foundation Trust, provided a presentation to the Committee.
During the discussion of this item, the following points were made:
· Dom Hardy thanked the Members, residents and all the organisations that had supported the Trust during the first wave of the pandemic, either by doing the right thing, providing donations or providing free food or services for staff. The Trust had been grateful for the solidarity, which had improved staff morale.
· The hospital was fully open with all services running. All necessary precautions such as PPE and social distancing were being taken.
· The Trust was keen that patients attended their appointments and were aware that some people had concerns about visiting a health care facility during the pandemic.
· The Trust had a number of aims over the winter;
Ø to deal with hospitalised Covid patients, although the number of people hospitalised during the second wave was not at the same levels as during the first wave. Whilst the prevalence of community transition had increased this had not translated into such a high hospital admittance;
Ø continuing to provide urgent care to non Covid patients;
Ø Sustaining major pieces of work such as the development of a Strategic Outline Case for a new hospital development. If this was successful an Outline Business Case would be developed followed by a Final Business Case. Councillor Miall commented that the survey on the mini site regarding potential options was now closed. Dom Hardy indicated that the Committee could send further comments to him if they wished.
· Services were currently running at normal levels and inroads were being made into the backlog, which had built up during the first wave. Services would be sustained so long as it was safe to do so.
· Members thanked the Trust for their hard work over the course of the pandemic.
· Councillor Frewin commented that he had heard examples of services such as the cancer services, continuing to run effectively during the pandemic. He commended the Trust on that achievement.
· Councillor Frewin asked about the outcome of the Prime Minister’s recent visit. Dom Hardy commented that he had visited in relation to the review of hospital food but the opportunity to impress on him the importance of investing in the health infrastructure had been taken.
· Councillor Frewin commented that Healthwacth had had feedback that the communications letters in the maternity service had not been updated to reflect Covid measures. Dom Hardy indicated that he would take this up.
· Councillor Firmager asked how long it was anticipated to be before the backlog in services, was cleared. Dom Hardy commented that there was an operational standard to ensure that no one waited more than 52 weeks for treatment. There were currently approximately 1200 patients effected, and assuming services did not have to be suspended, it was anticipated that the backlog would be cleared by April/May. Where patients had an urgent need e.g. cancer, they did not have to wait this long and treatment was expedited.
· Councillor Jones asked whether the Trust would be able to maintain stroke, heart attack and cancer services during the second wave. Dom Hardy indicated that it would and had also done so during the first wave of the pandemic. Whilst there had been speculation in the media that people were choosing not to attend appointments, the stroke team had undertaken an audit and found that the number of users this year was broadly comparable to last year. In addition, cancer patients were moved through the cancer pathway as speedily as possible.
· Councillor Jones asked whether other sites or hospitals had been used to create extra capacity. Dom Hardy indicated that some patients had been treated at the Berkshire Hospital, some orthopaedic patients had been treated at the Circle and Dunedin had undertaken some oncology and haematology treatment. Good patient surveys had been received across the Trust’s sites including West Berkshire Hospital, Prince Charles Eye Unit and the Townlands Memorial Hospital.
· In response to a question from Councillor Jones, Dom Hardy indicated that the hospital would have the ambition to potentially become a teaching hospital in the future.
· Councillor Bishop Firth asked about escalation plans should the situation in the second wave unexpectedly worsen. Dom Hardy stated that the Trust would use other sites in addition to the Royal Berkshire Hospital, and also independent sites. He re-emphasised that whilst the number of Covid patients admitted to hospital had increased from September, the hospital was not seeing the same level of admissions as during the first wave. Councillor Bishop-Firth asked whether hotels would be used in emergencies. Dom Hardy stated that this would likely be for social care provision outside of the acute sector.
· Dom Hardy indicated that Adult Social Care and in particular Matt Pope, the Director Adult Services, had been very supportive.
· Councillor Loyes commented that he had been informed by local mosques that there appeared to sometimes be delays in issuing a death certificate when a patient had died of Covid, and questioned why this was. Dom Hardy stated that he was not aware of any delays but that he would look into it. It could sometimes take a while for a death certificate to be issued if the Medical Examiner was delayed in establishing a cause of death.
· Councillor Loyes asked whether the Trust was confident that it could cope with the second wave of the pandemic as the usual winter pressures also began to take effect. Dom Hardy indicated that they were. There was a need to protect staff as well as patients and a sufficient supply of PPE was vital.
· In a few weeks’ time, asymptomatic testing would be rolled out to staff. Results would be known quicker, helping to reduce transmission amongst staff. There had been a slight increase in the number of staff off sick with Covid however cover arrangements and temporary staff could cover this.
· Councillor Loyes asked whether there had been an increase in the number of children hospitalised with Covid, and was informed that fortunately very few were seriously impacted unless they already had extensive underlying conditions.
· Councillor Frewin stated that he had seen in the media about the possibility of a hospital being built in Shinfield, and questioned whether this was speculation. Dom Hardy agreed that it was. Four options had to be provided in the Strategic Outline Case.
· In response to a question from Councillor Mather regarding access to Covid tests, Dom Hardy commented that the hospital had access to point of care tests for patients. Results were usually known within a couple of hours. Staff testing was through the south wing car park of the Royal Berkshire Hospital. Currently staff were being tested and self-isolating if required. Occupational health were helping to operate track and trace for staff.
· Councillor Mather questioned whether individual outcomes had improved since the first wave and was informed that whilst there had been some learning such as around the benefits of using CEAP machines and proning, there may be other reasons why less patients were requiring intensive care treatment.
· Councillor Mather asked whether the Trust had sufficient supplies of PPE and oxygen and was informed that it had a very good supply, the Trust being one of the only Trusts to make its own oxygen.
· Some funding had been provided upfront to make some initial improvements to the Trust’s estate, including the desteaming of the main hospital building, and the demolition of some of the most outdated buildings.
· With regards to the Covid vaccine, Councillor Jones questioned whether it would be mandatory for staff to receive it. Dom Hardy emphasised that staff would be strongly encouraged to receive the vaccine but that it would not be mandatory. There had been an over 70% take up of the flu vaccine this year, which was positive.
· Councillor Loyes asked whether Brexit would have an impact on the supply chain and was informed that during the first wave of the pandemic only 4% of PPE received by the NHS had been from UK based companies. It was now more like 70%. The Trust had its own supply and whilst issues could not be completely ruled out, Dom Hardy was more confident regarding the PPE supply.
· Councillor Miall asked whether A&E attendance had reduced. Dom Hardy indicated that during the first wave, A&E attendance had been two thirds of usual levels but during the second wave, attendance levels had not greatly reduced.
· Councillor Miall asked whether the Trust had reached full capacity at any point in the pandemic. Dom Hardy stated that there had been a shortage of surgical gowns during Easter weekend but this shortage had been managed through mutual aid and emergency deliveries.
· Nick Durman asked for an update on the phlebotomy services as a number of residents had informed Healthwatch that they had had difficulties in accessing the service. Dom Hardy stated that initially it had not been possible to offer phlebotomy services in the Royal Berkshire Hospital due to difficulties around social distancing. However, a bookable appointment system had now been introduced. Patients could also use West Berkshire hospital and the facility at Bracknell.
· Councillor Frewin emphasised that he was a Community First Responder and that they had seen a decrease in the number of inappropriate calls that they were being sent out to.
1) Dom Hardy be thanked for his presentation;
2) the presentation be noted.