London HUB - Success And Innovation In Response To An Unforgiving Pandemic

Success And Innovation In Response To An Unforgiving Pandemic

Elsie Mensah, Consultant Urologist1 Anna Goodman, Senior Specialist Lead for CMDU1 Daghni Rajasingam, Deputy Medical Director1 1 Guy’s and St. Thomas’ NHS Foundation Trust

The onslaught of the COVID 19 pandemic has had a pervasive effect on lives and organisations across the country and particularly on the National Health Service. Guy’s and St. Thomas’s has been at the heart of the NHS Covid -19 response from the onset. From the utilisation of systems and expertise through the trust’s High Consequence Infectious Disease Centre, and the rapid expansion of our critical care capacity, the trust rose to the challenge of meeting the evolving needs of patients. There was rapid redeployment and retraining of staff, implementation of new pathways and processes, all requiring careful leadership to ensure that service needs were met, whilst ensuring staff who were themselves going through the effects of the pandemic continued to be supported. There was also the successful roll-out of the Covid-19 vaccination program which spectacularly served employees, patients and indeed our prime minister!

May 2022

The Covid Medicines delivery Unit (CMDU) is an example of how innovative problem solving, collaboration, teamwork and leadership can translate into real world benefits for patients.

With increasing knowledge about the Covid-19 infection and development of novel treatments, the need to be able to provide treatment to reduce symptoms and hospitalisation was recognised and CMDUs were set up nationally to support clinically vulnerable patients who contract COVID-19 infection.

There was a short time period between the requirement for CMDUs and the need for these units to be able to deliver the service. The centre for innovation, transformation and improvement (CITI) at GSTT was tasked to provide support to CMDU at GSTT. They embedded improvement methodology into the workflow of setting up CMDU, which enabled the team to be very responsive to central policy changes and to continually improve quality of care.

The system initially utilised volunteers as well as staff working from home or self-isolating as well as redeployed staff, but currently also includes substantive staff. The team includes pharmacy, medical and nursing staff, administrative and the CITI team, all with the support and overarching leadership of their clinical leads and trust management.

May 2022

High risk patients with covid-19 are automatically referred via a web portal, or through clinicians and GP’s. Patients undergo a two tier triage system, firstly an administrative triage to ensure they meet relevant criteria and secondly a clinical triage to ensure patients would be clinically eligible for treatment. Medication is provided to patients via courier delivery if oral, or by arranging an intravenous infusion as appropriate. The figure below shows the numbers triaged and treated by the team from mid December 2021 – 13th of April 2022.

May 2022

There is a race against time and this can be challenging particularly when demand is high and staffing levels are low but the team remain committed to ensuring as many patients as possible are able to benefit from this service. They hold multiple daily huddles for ongoing improvement and problem solving to ensure they remain responsive to changes.

May 2022

Unsurprisingly, there has been very positive feedback from patients and families.