NHS Tees Valley Clinical Commissioning Group
Dear Parent, Carer
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:
- 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
- By default, use digital technology to provide advice and support to patients wherever possible
- 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
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
Tel: (01642) 263030
Designated Clinical Officer
Designated Clinical Officer
and orthotics and
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
• Patients who are unable to mobilise indoors due to faulty
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
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
Urgent rapid response/ swallow assessments will be done on a home visit
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
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 &
Urgent care needs will be prioritised.
Medium and lower priority work will be stopped to divert workforce to
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
Urgent care needs will be prioritised however
Hospital clinics continuing to take place via telephone and video
Where face to face appointment is required this will be arranged with the
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
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
Health visiting and school
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
• 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
• 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
• 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
• Rapid Response will continue to deliver community IVs
The above are examples in order to assist referral direction, it is not an
Specialist nurses for specific
• Respiratory/ COPD
Children specialist nurses for
• Cystic Fibrosis
• 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
• 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
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,
• 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
• Early supported stroke service will continue to avoid loss of
• 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
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
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