A message from Dr Nick White, Chief Medical Officer of NHS Shropshire, Telford and Wrekin
Dear colleagues,
Services across the health and care system in Shropshire, Telford and Wrekin are under extreme pressure due to a sustained and high demand for our health and care services. In the last week, our two Emergency Departments (EDs) have seen an average of 30 patients a day more than they would usually see. These are the Type 1 (very sick) patients, where the ED is the best place for the patients to be cared for. This is also a high number of patients with norovirus (diarrhoea and vomiting) and other respiratory illnesses such as Covid, flu and respiratory syncytial virus (RSV).
We know social care staff have been working tirelessly in the face of existing pressures, and I want to firstly thank all colleagues for your relentless focus on providing care to our safe, high-quality patients and residents.
The level of demand we have seen in Shropshire, Telford and Wrekin over the last few weeks is high and shows no sign of relenting. It is the same story across the country, and it is likely to get even more challenging; especially as we enter the festive period. These pressures are being felt across all of our partners and this is not just a hospital or A&E issue.
We are taking additional steps to prioritise and maintain safe services for patients. Where possible, we are bringing in additional staff to work in our communities and hospitals and maximising resources to manage urgent and emergency care pressures in all parts of our system. We aim to prioritise those with the highest needs and ensure that we continue to be able to manage life-threatening emergency care.
We know everyone is working exceptionally hard, and we appreciate everything that you are doing to ensure that despite the challenges we face, our services remain open to anyone who needs them. Partners are also working to ensure that staff are aware of the routes open to them for support.
We, along with our partners across the system, have issued an open letter, outlining the challenges we are facing as we head into the winter months. We are appealing to the public to only use A&E in life-threatening emergencies and offering advice on what they can do to protect themselves, their loved ones and our health and care services. To read the letter in full click here.
Things to be aware of/actions to take:
- Ensure (when appropriate) care homes check Recommended Summary Plan for Emergency Care and Treatment (ReSPECT Forms) before calling for an ambulance. The ReSPECT process creates a summary of personalised recommendations for a person’s clinical care in a future emergency in which they do not have capacity to make or express choices. The process is intended to respect both patient preferences and clinical judgement. The agreed realistic clinical recommendations that are recorded include a recommendation on whether or not CPR should be attempted if the person’s heart and breathing stop. For additional further information please see here.
- Care Home Staff Support – if you are concerned about a resident, please contact a member of Shropshire Community Trust Rapid Response or Virtual Ward Teams (7 days a week 8am-8pm) on 07974 080 415or 03333 584 584 for Single Point of Referral (SPR).
- You can also call NHS 111*6 in-hours or out-of-hours to seek advice. This service is available to all care homes across Shropshire, Telford and Wrekin. 111*6 is for all care homes who need fast access to a clinical team who can give advice and medical input needed for residents.
This is a separate service for care homes and means they will have a quicker response. If you dial 111*6 you will speak to a service advisor who will take the patient’s details and ask a few clinical questions. If admission is required, please ensure patients arrive at hospital with key information (key paperwork, medication, and essential personal items).
- New 24 hour Falls Response Service – From 13 November to 31 March EMED patient transport services (previously called Ezec) will have a vehicle staffed with 2 staff in operation across Shropshire Telford and Wrekin 24 hours a day. The benefits of the service are:
- Under an hour response service (pilot was average of 51 min)
- Frees West Midlands Ambulance Services up for category 2 calls.
- Supports SCHT Rapid Response service to review more people following a fall for risk of future falls and other health or social care concerns.
- Increases the number of people referred on to falls prevention/postural stability programmes in STW.
- EMED is a CQC registered service which enables the team to undertake assessment and the lift from the floor but also first aid and personal care reducing dependency on other services at the time of the fall.
Referrals can be made via the rapid response service 8am-8pm or via WMAS out of hours.
Rapid Response or Virtual Ward Referral line: 07974 080 415, 8am – 8pm, 7 days a week.
- New Call before you convey: West Midlands Integrated Care Board’s (ICB’s), Community Teams and West Midlands Ambulance Service University NHS Foundation Trust (WMAS) have collaboratively identified a consistent regional approach for ambulance clinicians to access community teams for a joint clinical discussion to support the right care for our patients whilst reducing harm – West Midlands Clinical Conversation Before Convey.
Launching on 18 December ambulance crews that attend a call to patients over 75 between the hours of 8am and 6pm will call the local community team number if that patient doesn’t have a life-threatening and emergency illnesses or condition/s requiring immediate treatment from or via ED. The intention is that suitable alternative services are used to support patients receiving the right care first time, whilst reducing pressure felt at EDs and ambulance handovers to help the ambulance end of shift burden (where a crew must wait until a patient is off-loaded at ED before finishing shift), as well as reduce length of stay.
Thank you for your continued support and relentless hard work.
Dr Nick White
Chief Medical Officer
NHS Shropshire, Telford and Wrekin
