Brougham Primary School

NHS TEES VALLEY COMMUNITY SERVICES UPDATE

Tees Valley
Clinical
Commissioning
Group
NHS Tees Valley Clinical Commissioning Group
21-04-20
Dear Parent, Carer
FOR INFORMATION
Sent on behalf of NHS Tees Valley Clinical Commissioning Group
Re: CHANGES IN ACCESS TO COMMUNITY SERVICES
Due to the massive impact of COVID-19, NHS England released guidance about releasing capacity
from community services to support the response in acute care. A list of priority areas have been
provided which Community Services providers must follow. These areas are:

  1. Support home discharge of patients from acute and community beds, as identified in the new
    Hospital Discharge Service Requirements, and ensure patients cared for at home receive
    urgent care when they need it
  2. By default, use digital technology to provide advice and support to patients wherever possible
  3. Prioritise support for high-risk individuals who will be advised to self-isolate for 12 weeks.
    In light of this, NHS England has issued guidance across Adult and Children’s services where
    community services should stop, or only be partially provided until 31st July 2020.
    We are working closely with North Tees and Hartlepool NHS Foundation Trust, South Tees Hospital
    Foundation Trust and County Durham and Darlington Foundation Trust to monitor the impact of the
    guidance.
    Below lists some specific areas where access to services has changed which are important that you
    are aware of and contact numbers for key services that your family use.
    COVID 19 is unlikely to cause a serious illness in children, but please remember children can still
    become seriously unwell from other causes that are always around. Please do not let concerns over
    COVID 19 stop you from contacting medical services. If you are not sure if your child needs to be seen
    please go to https://www.what0-18nhs.uk/national for advice or contact 111 or your GP. If you think
    your child is seriously unwell call 999.
    If you have any queries please do not hesitate to contact the DCO for further support.
    c/o North Ormesby Health Village
    14 Trinity Mews
    Middlesbrough
    TS3 6AL
    Tel: (01642) 263030
    Yours Sincerely,
    Ruth Kimmins
    Designated Clinical Officer
    Ruth.kimmins@nhs.net
    Rachael Wilcox
    Designated Clinical Officer
    Rachael.wilcox2@nhs.net
    Service Status
    Wheelchair, prosthetics
    and orthotics and
    Community Equipment
    service
    No service for standard new assessments / new specialist seating referrals.
    Will complete clients already part way through their bespoke specialist
    seating fitting to ensure product remains relevant?
    Will also review:
    • Patients requiring Wheelchair therapist input for pressure ulcer
    management
    • Patients who are unable to mobilise indoors due to faulty
    wheelchair
    Rosscare will continue to be the point of contact for patient
    repairs/servicing for all URGENT repairs as meet the criteria above
    TCES continues to operate in the tees Valley to provide community
    equipment to enable discharge from hospital, urgent community requests
    and for repairs
    Audiology services Service continues with Skeleton Staffing .
    The service has stood down non urgent activity but will provide repair,
    replacement and supply of spare parts and specialist batteries
    Patients with suspected foreign body in ear(s) or sudden unexplained
    hearing loss should be directed to 111/urgent treatment centres
    Podiatry and podiatric surgery Service stood down except for:
    • High risk vascular/ diabetic
    e.g. Diabetic foot clinics
    MSK/Physio Service stood down except for:
    Urgent referrals will be processed.
    All referrals undertaking telephone triage. Focus on self-management
    Post-surgical rehabilitation will be provided where deemed clinically
    necessary (e.g. urgent/complex cases).
    Continence Only urgent patients to be seen.
    Patients should contact the delivery service in the usual way to re-order
    products.
    Assessment and re-assessments will continue via telephone triage
    Speech and Language Therapy
    (Adult and Children)
    Service stood down except for:
    Urgent communication and voice disordered patients will be treated by
    telephone.
    Urgent rapid response/ swallow assessments will be done on a home visit
    basis only.
    Swallow reviews will be done by telephone if possible otherwise will be
    carried out by home visit
    All Children and Young People have been screened for Priority during this
    time and therapists are making direct contact with families
    If you have any concerns and require advice please contact the service via
    phone numbers listed below :-
    Hartlepool, Stockton and Darlington 01429 522471
    Middlesbrough and Redcar 01642 944488
    Dietetics (Adult & Paediatric) Telephone clinics for clinically urgent (as triaged by Dietitian) new and
    review.
    If capacity becomes smaller then this will move to new only
    Orthotics Only high risk appointments to be maintained:
    Patients requiring an Orthotist input for pressure ulcer management (E.g.
    High Risk Diabetic Clinics)
    • Patients who are unable to mobilise indoors without Orthotics
    • Paediatric patients with long term health conditions whose
    condition would deteriorate without input from Orthotics.
    • This is an essential service for some children to walk. This service is
    still running where assessments are mid provision but no new
    assessments are happening.
    Children’s Physiotherapy &
    Occupational Therapy
    Urgent care needs will be prioritised.
    Medium and lower priority work will be stopped to divert workforce to
    critical areas.
    Telephone calls are being undertaken and where clinically indicated home
    visits are taking place. Video consultations are being commenced
    If you are concerned and need some advice please contact the teams on the
    numbers listed below
    Darlington OT central admin: 0191 387 6359
    Physio central admin: 0191 387 6346
    Hartlepool, Stockton 01429 522471
    Hartlepool and Stockton Special Schools 01642 944506
    (Ash Trees, Abbey Hill Springwell and Catcote only)
    Middlesbrough and Redcar 01642 944506
    Community Paediatricians and
    Community Nurses
    Urgent care needs will be prioritised however
    Hospital clinics continuing to take place via telephone and video
    conferencing
    Where face to face appointment is required this will be arranged with the
    family
    Community nurses and specialist community Nurses
    Urgent care needs will be prioritised
    Clinics have been cancelled however
    Telephone reviews are taking place, where clinically indicated home visits
    will be arranged for specific health interventions such i.e. infusion PEG
    changes etc.
    Equipment will continue to be still be delivered
    Mental Health and Learning
    disabilities CAMHS (TEWV)
    All community teams are completing a prioritisation process for those at the
    highest risk and contact being made as clinically determined
    Roll out of telephone and video consultation has commenced
    If you are concerned about you child or young person’s mental health and
    need some advice and support please contact the Single Point of Access
    number 0300 013 2000
    The crisis service is still operating and the contact number is
    0300 013 2000 option 6
    0-19 services
    Health visiting and school
    nursing
    Clinics have been stopped
    Telephone consultation taking place. Where home visits are clinically
    indicated these will be arranged with families
    Early years concerns to signposted to Health visiting
    Darlington 03000 030013
    Hartlepool South Locality 01429 292444
    North Locality 01429 292555
    Middlesbrough 03003 031603
    Redcar 01642 444011
    Stockton on Tees 03333 202302
    Community Nursing Services
    (inclusive of Community
    Matrons, Rapid Response and
    District Nursing Services)
    • Service provision will continue but the service will clinically prioritise
    urgent needs and ensure dynamic case load management.
    • There will be a reduction of regular review work through appropriate
    risk assessment.
    Teams will:
    • Monitor rising risk of deferred work if disruption continues.
    • Continue support in last days of life of or high complexity palliative
    care – syringe drivers and symptom management and any other
    identified clinical need.
    • Prioritise response to rapidly deteriorating patients to facilitate
    admission avoidance.
    • Prioritise early supported discharge from acute settings
    • Deliver insulin administration
    • Deliver low molecular weight heparin injections
    • Where Nursing intervention is required, medication prompts will be
    supported
    • Deliver wound care where there are immediate concerns regarding
    the patient’s condition e.g. infected wounds, heavily exuding wounds
    and compression bandaging that has been in situ for more than 7 days
    • Deliver bowel care where this is required on a regular basis
    • Prioritise visits for:
    • Palliative and End of Life Care
    • Complex wound management, including Diabetic foot (in
    conjunction with podiatry services)
    • Urgent Catheter care
    • Community Matron’s will continue to focus on Care Home
    admission avoidance
    • Rapid Response will continue to deliver community IVs
    The above are examples in order to assist referral direction, it is not an
    exhaustive list
    Specialist nurses for specific
    conditions:
    • TB
    • Respiratory/ COPD
    • Diabetes
    Children specialist nurses for
    example
    • Oncology
    • Cystic Fibrosis
    • Haemophilia
    • Duchenne’s
    • Routine QOF associated activities will stop.
    • There will be an increased use of telemedicine options wherever
    clinically safe to do so.
    • Routine annual reviews of respiratory LTCs will be delayed EXCEPT in
    people with known frequent exacerbations e.g. asthma/COPD.
    • Routine annual review of CVD based LTCs (Diabetes/IHD/CKD) will
    continue given the biochemical testing involved to identify endorgan damage
    • Community diabetes nursing teams will stop clinics and education
    courses and will divert attention to support acute teams to help with
    inpatient diabetes advice.
    • Services will monitor rising risk of deferred work if disruption
    continues
    • Contact your regional Children’s specialist nurses who can advise on
    the latest guidance and support for your condition.
    Diabetic Eye Screening Routine Digital Screening is postponed
    If patients notice any sudden loss of vision they are to contact eye casualty
    at JCUH
    Digital Surveillance patients who are seen more than once a year are
    being assessed individually, including pregnant women.
    Adult Therapy interventions
    (Physio, speech and language,
    occupational therapy, dietetics,
    orthotics)
    • There will be prioritisation of urgent care needs (including
    malnutrition and enteral feeding support)
    • Medium and lower priority work stopped. Monitor rising risk of
    deferred work if
    • Provision to continue for people at high risk of aspiration pneumonia
    due to difficulty with swallowing e.g. people with progressive
    neurological conditions (MS/PSP/MND etc.)
    • Swallowing assessments will continue to prevent aspiration
    pneumonia
    • Early supported stroke service will continue to avoid loss of
    rehabilitation potential.
    • There will be dietetics support for people with significant
    malnutrition and increased risk of frailty and functional disability
    • Face to face pulmonary rehabilitation classes will stop. Options for
    Virtual Pulmonary Rehabilitation are being explored.
    • There will be prioritisation of Respiratory Physiotherapy
    GP 111 acute services and 999 GP practices are all still open and they are undertaken telephone
    consultations
    If you GP identified that child or young person needs to be seen in practice
    an appointment time will be provided to attend
    If you are concerned about child or young person’s health you can contact
    111 for advice
    Paediatricians are still working and contactable via their secretaries via main
    switch board at each acute trust for advice
    If your child or young person becomes very unwell contact 999 or take to
    A&E
    During the COVID 19 pandemic clinical staff within the acute trust may
    be working in different roles/ areas
    Please we aware if you make contact with services that you may not
    be able to speak to your usual named health worker, but staff will
    have access to your child’s medical records and will be able to still
    provide advice and guidance

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Brougham Primary 5 12 2016

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