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Rising to the challenge: a spotlight on the COVID-19 response 

This month we'll be casting a spotlight on the professional lives of SLTs fighting against COVID-19. Pauline Downie, the RCSLT’s Scotland representative, Dr Sally Archer and colleague Claire Twinn from Guys and St Thomas' NHS Foundation trust shared their insights and response to the early days of the pandemic.To read the full features, please see our May issue.

Be calm. Stay wise. Be kind

Pauline Downie shares the response of NHS Lanarkshire’s speech and language therapy service to the start of the COVID-19 outbreak

By mid-March, NHS Lanarkshire speech and language therapy service had received its first referral of a patient with suspected coronavirus, and our first member of staff was also off with symptoms. Since then, we have been working at speed to make the service changes necessary to combat the spread of COVID-19, and to ensure all NHS staff and resources are used to best eff ect. To give you an idea of the pace of change, I have documented how the next few days in March played out:

  • On Monday 16 March, we were advised to cancel all non-essential meetings and training.
  • On Wednesday 18 March, we were told to cancel all routine patient activity and an announcement was made that schools were to close on Friday of the same week.
  • By Thursday 19 March, a decision was made to use some of our clinic rooms as Community Assessment Hubs. SLT staff spent Wednesday to Friday retrieving records and IT equipment from schools, and clearing out the clinic rooms. At the same time, we started carrying out clinical triage so that we could focus on high-risk patients and clients.
  • On Monday 23 March, the government announced a lockdown and everyone except key workers was advised to stay at home (apart from to undertake food shopping and other essential activities).

As head of speech and language therapy, my role in this situation has been to provide leadership and co-ordination, to look after staff wellbeing, and to provide clear communication to staff , stakeholders and, via line management structures, to the AHP director and into the command structure.

At the time of writing on Thursday 26 March, all routine management functions have been suspended: we are only dealing with issues around staff pay or absence. All our energy is going into caring for our high-risk patients and preparing our staff to move to new roles. 

Read the full article here.

When a marathon becomes a sprint

Dr Sally Archer and Claire Twinn on the race to build and sustain the COVID-19 response at Guy’s and St Thomas’ NHS Foundation Trust

It seems like a lifetime ago that our trust put out a statement on its social media platforms that it was treating its fi rst patient with coronavirus. It reassured the public that all of our services remained open as usual. Th at was on 6 February, and, since then, the hospital and our ways of working have changed almost beyond recognition.

We work at Guy’s and St Thomas’ NHS Foundation Trust in central London; at the time of writing (early April), London reportedly has almost double the number of cases of COVID-19 than any other part of the UK, and our local boroughs of Lambeth and Southwark have been hit hard. Having been an early high consequence infectious disease centre (HCID) with a large critical care department, it is unsurprising that the number of patients with the virus at our trust has increased rapidly.

Now, at the end of a week in which we have reached a milestone at St Thomas’, where all of our adult inpatient referrals to SLT were COVID-19-positive or suspected of being so, we have taken stock of how far we have come and what it has taken to get here.

Moving mountains

The trust has moved mountains to increase capacity and meet the challenge presented by coronavirus; the speech and language therapy department has been working flat out on this cause, too. Our outpatient services, as well as voice, cancer and general, have completely transformed—an enormous piece of work involving careful clinical triaging and the development of robust systems and risk assessments to ensure that all patients are accounted for and managed safely.

All outpatient appointments in the voice service, and the majority of our cancer and general outpatient services, have been converted to either telephone or virtual appointments using specific
online software. This is a completely new way of working and not without its challenges, both technical and clinical; it has taken a huge amount of work to implement this change so quickly and efficiently. Partnerships between clinical and administrative staff have been key, with the admin team being integral to ensure the correct coding of appointments, as well as dealing with huge volumes of telephone queries from patients.

Our inpatient service has been subject to significant change on a daily, if not hourly, basis. Not only have we seen many new wards opening, we have also seen a dramatic increase in the number of critical care beds, with plans for more discussed daily. Patients with COVID-19 or suspected COVID-19 are being cohorted within dedicated wards and we have had to fl ex our usual speech and language therapy ward allocation accordingly. This means a significant change for all therapists, with many working in unfamiliar areas as a result. 

Read the full article here.

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