Teams may be struggling to organise and maintain emergency level service for chronic disease patients (especially those in the shielded and at risk groups). This letter has been sent to all CEOs of NHS Trusts in England and is being disseminated to the national leaders of the NHS in the devolved nations.
It is posted here for the benefit of all our members.
From GIRFT Lead for GI and Hepatology and The BSG President
To reduce pressure on inpatient services during the COVID-19 pandemic it will be essential for trusts to ring-fence some specialist staff to keep patients with long-term high-risk conditions from becoming unstable in the community, leading to emergency admissions that could be prolonged and life-threatening.
Specialist Nurses are highly sub-specialised and likely to be better utilised in this way, rather than being redeployed in unfamiliar areas and ending up working as Healthcare Assistants. Gastroenterology has a significant number of patients in high-risk categories, such as those with cancer and those on immunosuppression, who may have to self-isolate for prolonged periods. Triaging, vetting and fielding urgent referrals from GPs and high-risk patients will be essential, as will ongoing treatment and monitoring of high-risk conditions (cohorted infusion services, paracentesis etc).
Staff with significant comorbidities and recently retired staff coming back into the NHS to help with this crisis may also be in high risk groups, more vulnerable to the effects of COVID-19. Utilising such staff, as well as those who are well but having to self-isolate, to do none face to face work of this nature will also be extremely valuable to help protect patients and front line staff.
We strongly urge all hospitals to take this approach in workforce planning – one or two staff assigned to non-contact triage and support could reduce impact on frontline service management and prevent further unnecessary contagion. Administrative support for this tranche of work will need to be maintained.
Cathryn Edwards, BSG President
Beverly Oates, GIRFT Lead for Gastroenterology and Hepatology