Dear All,

In these uncertain times, I wanted to send out a message of support to everyone who works in Acute Internal Medicine, recognising the great work and effort our teams are showing, even at their own personal cost. Acute Medicine has always been a specialty where the team is vitally important, and over the coming weeks and months, this is going to be more crucial than ever before.

I know there is great anxiety regarding spread, isolation/social distancing policy and how hospitals will cope. I know my own Trust is mobilising strategy and change in a way that has never been seen in the NHS before, and when this is all over, I wonder if the NHS will have found a new way to function, more in line with its modern day needs and just as strong as before. I hope everyone has seen the SurveyMonkey regarding preparedness-we are planning on running another in a few weeks’ time to catch up on what will be happening. I am hearing that London is particularly badly hit-and we all feel for our colleagues there and send them our best wishes- where I am in Yorkshire, there is an eerie ‘calm before the storm’ feeling and we are using this time to learn from colleagues who despite being less fortunate, are sharing their experiences with others-thank you all.

I think it is important to try and remain positive-we know that for the majority, the virus will produce a mild but possibly unpleasant illness, but the overall risk is low. We should be leading by example with our hand hygiene measures and social distancing. I also think that social media (certainly for me) has heightened some anxieties and we must all see it as our responsibility to tweet/post in a responsible manner-I am sure that you have noticed that we have been quieter in the media in the last few weeks-this isn’t because we haven’t got anything important to say, more that we have made a conscious decision to only comment within our own expertise-I think this is the correct approach.

For our trainees up and down the country-please be assured that we are working hard to ensure that training needs will be met and that we are doing everything we can to minimise the stress of worrying about progression-there has been very reassuring advice from the SAC and the JRCTPB in this regard.

From a SAM conference point of view, we will be back in Glasgow in the Autumn, followed by Liverpool in Spring, then in Autumn 2021 we will hold our delayed ‘SAMLondon’. I hope you all can understand the decision to cancel (it was the right thing to do) and I am most sad for Nick M and Tam-the local organisers who had developed a programme that was probably our most exciting and adventurous yet- Autumn 2021 seems like a long time to wait for it! They both deserve a huge amount of gratitude for their work so far.

These are the take home messages:

• Look after each other. Everyone has different thresholds and recognise that we all need time away from the frontline, even if it’s a coffee at the front door.
• Look after the rest of the team-other health care professionals, students, nurses, ACPs, PAs, doctors in training and non training grades. None of us has seen anything like this before. We are all learning on the job. Acknowledge and support this.
• If you need to self isolate whilst asymptomatic (and I am a bit of an expert in this!) support your team in other ways if you can, but most of all try not to feel guilty-this is a marathon not a sprint. If you are symptomatic-you are ill-take time, rest up and get well.

I hope that you all stay safe and well.

 

Sue

 

How are NHS hospitals facing COVID19?

Thank you for completing the COVID 19 Survey at this critical time. The survey will be redone in May.

A snapshot survey of SAM members March 2020

 

1. Only a quarter of hospitals have started preparations more than a week ago.
2. Two thirds of hospitals have a triage tent or POD outside their hospital.
3. Four out of five Emergency Departments and Acute Medical Units have completely or partially split their department for COVID and Non-COVID patients.
4. Units are preparing for very variable numbers of patients, 1 in 6 units is expecting to use less than 30 and 1 in 6 more than 100 beds. This must be taken in context as units vary in size and number of admissions.
5. Half of the triage for COVID is undertaken by senior nurses, the other half is split between senior and junior doctors,
6. More than half of the units are using telephone triage as their first line of defence prior to a physical encounter.
7. Only one in six Acute Medicine teams is not involved in looking after patients with COVID19.
8. Worryingly over half of the doctors and nurses that look after patients with COVID will also look after patients without COVID in the same shift.
9. Less than half of the staff are satisfied with the protective equipment giving a score of 42 of possible 100 points to provision of protective equipment. Concern about personal protection equipment and slow turn-around of tests dominated the free text section. This survey was done before the revamped delivery of PPE to Trusts last week, and a repeat survey in the next few weeks may well highlight improved confidence in supplies.