Coronavirus - Health Advice

Health - Covid-19 Data for Powys

It is disappointing that different data is reported to measure deaths and confirmed cases. This clearly causes confusion.

I am pleased that Powys Teaching Health Board uses the latest available data, including from the Office for National Statistics (ONS). The ONS weekly report includes all deaths where COVID-19 is mentioned on the death certificate.

Currently the ONS is reporting that sadly 65 people from Powys have died with confirmed or suspected COVID-19. This includes deaths in hospitals in both Wales and England, deaths in care homes and deaths in people’s own homes. This figure gives a much fuller reflection of the impact here in Powys than other reports which may only include deaths in Wales, or those where COVID-19 has been confirmed in a laboratory test.

The latest information (12 May) from Public Health Wales indicates 216 positive test results for Powys residents based on tests undertaken in Wales. This only reflects people who have been tested in line with the Welsh Government's testing strategy, and the figure will be slightly higher if tests in England (e.g. hospital patients) are also included.

For useful reference, the Wales Chief Statistician has published a blog which explains in more details the differences in data. You can read this here.

You can find out more about COVID-19 data from the Powys Teaching Health Board website here.

 

The local situation here in Powys

I have recently spoken with Carol Shillabeer, CEO of Powys Teaching Health Board (PTHB), and senior members of her team during which they reiterated that Powys Teaching Health Board has a five point plan:-

  • Powys Community Care: Increasing the beds and skills in Powys to provide local care, to reduce the need for acute hospital care, and to support people to return from acute hospital quickly and safely
  • Powys Primary Care: Enabling local access to health and care within local communities, including rapid assessment for Coronavirus
  • Acute and Specialist Care Partnerships: Strong relationships with neighbouring hospitals for access to acute and specialist care for the people of Powys
  • Self Care, Families and Support:  Supporting people to maintain their health and wellbeing
  • Stay Home Save Lives: We all share a responsibility to reduce the spread of infection

 

Powys Community Care

A key part of Powys Teaching Health Board's local plan is to increase the number of beds available in local community hospitals. All hospitals and health & care centres here in Montgomeryshire including those in Llanidloes, Machynlleth, Newtown and Welshpool have a vital role to play. PTHB are putting in place 100 additional beds so that they can care for many more patients, sicker patients, in the county.  Right now, many of the beds are empty but this is the right thing to do so that they are ready for the expected demand in the coming weeks. Find out more here: www.powysthb.wales.nhs.uk/news/52425 

 

Powys Primary Care - GPs, Pharmacies, Dentists & Optometrists

Fewer attendances at A&E departments reduces the pressure on NHS staff, who are working hard to defeat Coronavirus. However, patients with health problems should not stay away because of concerns around Coronavirus. The advice from medical professionals remains the same: if you feel seriously unwell, be it a heart attack, stroke, or an injury, then you should still attend A&E for treatment, because a patient presenting with something serious could actually put more strain on resources – and risk their life – by delaying.

Primary care services in Powys also remain OPEN. Across the county, GP services, pharmacies, dentists and optometrists have needed to make temporary changes to respond to the extra challenges of Coronavirus. These changes aim to keep you safe, keep staff safe, and keep services running. It is really important that people continue to use local primary care services. 

GP services across the county remain open. There may be some local changes to the way the provide this, including services such as telephone assessment. Please check with your practice for details. Find out more here: www.powysthb.wales.nhs.uk/news/52289   

Some GP practices are working together to offer primary care assessment hubs – dedicated facilities for people with suspected or confirmed Coronavirus – so that you have rapid access to advice and support when you need it. Find out more: www.powysthb.wales.nhs.uk/news/52429   

Eye care (optometrists) are working together to provide eye care hubs for urgent eye health advice and support. Find out more here: www.powysthb.wales.nhs.uk/news/52356  

Community pharmacies changing their opening hours and reducing the number of people in store so that they can continue to provide vital high street services. Find out more here: www.powysthb.wales.nhs.uk/news/52337   

Local dental services are also working together to provide telephone assessment, and to refer you to dental hubs for urgent and emergency dental care. Find out more here: www.powysthb.wales.nhs.uk/news/52341   

During Coronavirus, it also remains vitally important that people receive appropriate care at the end of life, that we have appropriate dignity for the deceased, and that we can access support for grief and loss. Powys Teaching Health Board are putting in place a wide range of plans, which include working with partners to increase mortuary capacity in the county. Find out more from: www.powysthb.wales.nhs.uk/news/52381  

 

Non-Covid Primary Care Services

Cancer Research UK has said that the Welsh response to cancer care during the Covid-19 pandemic has been “slow” in comparison to England.

There has been disruption to cancer care services during this pandemic, especially as some staff or wards have been redeployed to treat people with the virus.

However, what concerns me is that, according to statements from Wales' clinical cancer care director, Professor Tom Crosby, only about a quarter of urgent referrals are being dealt with.

The British Medical Association has also said that of the 835 doctors in Wales who it surveyed, some 40 percent (335) reported that care for patients not affected by the virus has significantly worsened, with a further quarter claiming it has worsened slightly.

Clearly, patients need the reassurance that services will be safe and the Minister for Health must consider a range of options to treat cancer patients in a safe and accessible environment.

All options must be looked into, including designating hospitals to treat these patients completely separately from Covid-19 patients in Coronavirus-free settings.

Primary care services must be maintained. We cannot let the treatment of one set of patients suffer while we tackle the illness of another group, however unprecedented the circumstances.

 

Acute & Specialist Care 

Some people with more serious illnesses will need to be admitted for specialist and critical care, with specialist teams and equipment to give them the best chance of recovery.

Patients with more serious complaints, worse symptoms of Coronavirus, or requiring intensive care, will continue to be treated in district general hospitals. 

Welsh Government has made clear that across Wales there are no plans for field hospitals to provide critical care. Instead, the steps which Powys Teaching Board are taking locally to expand its own hospital capacity will help to free up vital district general hospital capacity for people who need it. Community sites will provide local care, including “step down” care for patients who are recovering. Find out more here: www.powysthb.wales.nhs.uk/news/52340   

 

Changes to Health Services in Powys

Powys Teaching Health Board have needed to make some changes to local NHS services to keep you safe and keep staff safe. Some of these changes include: 

  • Reducing the number of visitors to help reduce the spread of infection – you can find out more at www.powysthb.wales.nhs.uk/news/52336  
  • Pausing routine and planned care appointments except where these relate to conditions that directly threaten life, limb or sight 
  • Putting in place more telephone and online services to reduce face-to-face contact which may spread infection 
  • Reorganising services to respond to staffing challenges when staff are self-isolating or shielding 
  • Reducing the number of people who can enter a building or facility at one time, to help with social distancing 
  • Introducing additional closed hours during the day to catch up on essential tasks such as cleaning, prescriptions, or phone calls to vulnerable patients 

Powys Teaching Health Board also have an information line on 0345 602 7053 if you cannot find the answer through your normal route. This is open 9am to 5pm, seven days a week. You can also find out more by visiting their website here: www.powysthb.wales.nhs.uk/coronavirus  

 

Relaxation of restrictions with specific medical needs

The Welsh Government has finally relaxed the restrictions for people with specific medical needs in Wales, two weeks after the guidance was amended in England. This is very welcome for the families who have people with specific medical needs, including individuals with learning disabilities or Autism. More information is available here: https://gov.wales/sites/default/files/publications/2020-04/the-health-protection-coronavirus-restrictions-wales-amendment-no-2-regulations-2020.pdf

 

Emotional & Mental Wellbeing

During an extended lockdown period, our emotional and mental wellbeing becomes ever more important. There is support available through Powys Teaching Health Board's free online Cognitive Behavioural Therapy platform provided by SilverCloud. Find out more here: www.powysthb.wales.nhs.uk/news/52391   

A wide range of resources to support our mental, physical and social wellbeing are also available through a new national campaign led by Public Health Wales. The How Are You Doing? Campaign aims to support people in Wales to look after their wellbeing during the lockdown period. Find out more from Public Health Wales: https://phw.nhs.wales/howareyoudoing   

 

Domestic Abuse

Sadly, during times of crisis, incidents of domestic abuse increase. The Coronavirus crisis is an anxious time for all of us, but doubly so for those who are trapped in their homes with an abuser. We all need our homes to be a place of safety, not a place of fear, abuse and violence. Help is available, and the Live Fear Free helpline offers 24/7 support. Remember that travel to escape abuse is definitely essential travel. Find out more here: www.powysthb.wales.nhs.uk/news/52444

 

Working with the Army to Strengthen Supply Chain for PPE 

I've had a number of people, including local doctors, nurses and those working in social services, contact me regarding the provision of Personal Protective Equipment for health and social care staff.

Powys Teaching Health Board has informed me that it is distributing the PPE which it receives from Welsh Government to staff across the health board area and that they have made sure that the issues raised with them by local staff about PPE have been shared with the Welsh Government.

It is essential that those who need PPE have access to it. All four UK Governments are working together on a UK-wide strategy which will ensure equipment continues to be evenly distributed across the entire nation. As Wales is a relatively small country in a global market, we are better off sourcing this equipment together.

In times of crisis, our Armed Forces always rise to the challenge by making themselves available to support our communities and defend them from threats. We need to take advantage of every asset at our disposal to save lives and relieve pressure on our NHS so I'm pleased that a partnership between Powys Teaching Health Board and UK Armed Forces is strengthening the supply chain for PPE in the county’s NHS.

Find out more about PTHB's partnership with the Army here: www.powysthb.wales.nhs.uk/news/52453  

 

Shielding
 

Following a refinement of the medical criteria for shielding, and in line with the other three nations, the Chief Medical Officer for Wales will be sending letters to further high risk patients advising them to shield. The majority of these patients are within the high-risk categories already identified and have been identified as a result of updated searches of secondary care systems. In addition to these groups, the 4 UK Chief Medical Officers recently agreed that all those on kidney dialysis should be advised to shield.

As a result, approximately 21,000 patients have been added to the Welsh Shielded Patient List (taking the number advised to shield in Wales to approximately 121,000). Updated searches of primary care system are still being conducted centrally and may identify further patients who will also receive a letter from the Chief Medical Officer.

The list of high risk conditions is under constant review to ensure that those who need to shield are identified and contacted. Given the severe nature of the measures which those who are shielding must take – self-isolation for 12 weeks which includes reducing all non-essential contact with other household members – it is important only those are classed as high risk are added to it.

In line with the initial 12 week shielding advice issued in late March, the latest letters advise people to shield until at least 15th June 2020.

Local authorities and the major food retailers will receive the updated Welsh Shielded Patient List at the same time so that the additional people identified can access the support being provided.

For example, I'm aware that Sainsbury in Welshpool have been going above and beyond by personally shopping and delivering products to vulnerable customers who are shielding and are continuing to expand their delivery capacity and provide delivery slots to customers who have been identified by the Welsh Government as extremely vulnerable.

 

Supermarket Deliveries

I have asked for feedback from people across Montgomeryshire on their experiences when trying to get supermarkets to deliver to their home. It is clear that experiences vary, depending on where people live and which supermarkets they are using. For example, someone identified as a vulnerable person in Aberbechan area has been able to get Sainsbury's weekly deliveries. Another resident has reported that only Tesco and Asda deliver to SY10 area (Llanrhaeadr Ym Mochnant). Someone in Machynlleth has struggled to get Tesco deliveries. Someone else in the SY15 area has said they haven't yet been able to get deliveries from Asda, Tesco, Sainsbury's nor Morrisons. Another resident has said that Tesco have limited their online orders to 80 items, which has caused problems for a family of 6. Someone else has found that Asda and Iceland have been really efficient with deliveries.

However, it seems that the supermarkets are working hard to increase the delivery slots available and also to cover more areas. The above situations may have changed already. Newtown Morrisons has reportedly increased the area it is delivering to - and now also covers from Carno to across the border.  Morrisons in Welshpool have said that they are doing doorstep deliveries. The elderly and vulnerable can ring a dedicated hotline and the items will be delivered the following day by their staff.

Tesco have also said they have increased their drivers and their fleet - vulnerable customers can book a priority slot online. Information provided to me has said that if you don't currently have an account with Tesco but have received a letter from the NHS because you're classified as clinically vulnerable, you can create an account on their website or call Tesco on 0800 917 7359.

Aldi also have set up a Food Parcel delivery service - https://www.aldi.co.uk/food-parcels 

These are all people's personal experiences and so it may vary for you, but I thought I'd share this information in case it is of assistance to you. 

Montgomeryshire residents have also been positive and industrious in forming groups of volunteers to facilitate food shopping, collect prescriptions etc. You can find a list of local Facebook groups on the Powys County Council website - https://bit.ly/powyscommunity - or by all means call my office on 01686 610887 if you want to know about a group serving your area.

You can also contact Powys Community Connectors for more information on volunteer groups who can help you. Funded through the Powys Regional Partnership Board – the Powys Community Connectors have been quick to increase capacity to support vulnerable people. In a typical month they receive 200 referrals for community support. By 23 April they had already reached 1000 this month alone. They have provided a wide range of support including help with prescriptions, befriending, connecting people with local community networks, advice and support for people who are shielding, and providing support for mental and emotional wellbeing. The Community Health and Well-Being Coordination Service is available on 01597 868649 or community.connectors@pavo.org.uk

 

Volunteering

Powys Teaching Health Board have also seen a tremendous response to the call for volunteers in the county. Hundreds of people have come forward with offers of help. As the impact of Coronavirus increases in the weeks ahead, they will be ready to deploy these volunteers into support roles across the county. 

 

The COVID Symptom Tracker

A vital part of self care is using the online symptom checker to check symptoms. There has been an enthusiastic response in Powys to a new app to track COVID symptoms across the UK. The COVID Symptom Tracker - https://covid.joinzoe.com - helps the NHS to understand how people are feeling. It takes just 1 minute to report your health daily, even if you are feeling well.

Find out more from NHS 111 Wales: http://111.wales.nhs.uk/covid19

 

Testing

Here in Powys, a new mobile testing units will be travelling around Powys, operated by the Armed Forces in partnership with the Dyfed Powys Local Resilience Forum. 

The unit, which was in Newtown at the end of last week, forms part of the UK-wide response to Coronavirus and will bring testing closer to home. It has launched as an appointment service for priority groups such as critical workers and care homes. They will also put us in a strong position when testing is expanded further.

Mobile testing units can be set up in under 20 minutes. Specially trained Armed Forces personnel will collect swabs at the mobile sites, before they are sent to laboratories for processing. The aim is for all test results to be reported within 48 hours.

A new online eligibility checker is available for Key (Critical) Workers in Powys to help them book an appointment at new mobile testing units in the county. The online eligibility checker is available here.

More information about the Welsh Government’s approach to Coronavirus Testing is available from the Welsh Government website.
 

Testing Capacity in Wales

The increase in the number of tests for healthcare and care home workers in Wales is welcome but more is needed.

Testing capacity here in Wales has only increased by roughly 4,000.

Worryingly, less than 10 per cent of our healthcare workers are being tested which, quite frankly, is unacceptable.

To illustrate this, it is  disappointing to hear of a survey which was recently carried out by the Royal College of Nursing Wales into members’ experience of Coronavirus testing in Wales.

There were 1,215 completed responses from Wales and only 50 percent of respondents knew how to access or apply for testing in their place of work. Of the 45.8 percent of respondents who currently require, or have previously required, testing for Coronavirus, less than half of them (45.9 percent) were offered a test. 

There needs to be an urgent increase in the numbers of health and social are staff who are offered a test, as well as increased and enhanced partnerships with trade unions and professional bodies to help communicate key messages on testing guidance and provisions at a local level.

I think that it was a mistake for the Welsh Government to abandon the 9,000 tests per day target because the decision has led to the Welsh Government taking its eyes off the ball.

I believe that the introduction of a dedicated team to manage the current testing programme would improve the current testing number.

Care Home Testing

I am pleased that the Welsh Government has reconsidered its original decision and started testing residents and staff within care homes where an outbreak of Covid-19 is occurring and potentially in neighbouring care homes as well. The new additions to the testing regime in Wales will also see repeat testing the following week.

The new mobile testing units and home testing kits will be focused towards care homes to ensure testing is easily available. Testing will also be available in the largest care homes (those with more than 50 beds) which are at greater risk of experiencing an outbreak because of their size.

 

Vaccine Taskforce

The UK Government has announced the creation of a Vaccine Taskforce which will aim to develop and manufacture vaccines to fight Covid-19. The taskforce will be undertaking enormous amounts of work to develop vaccines and will ensure no stone is left unturned. Of course, there is no guarantee of a success but this is an extremely positive announcement and I’m sure its results will be fruitful.

 

Support for Hospices

Although I have welcomed the Welsh Government’s announcement of additional support of up to £6.3 million funding for hospices in Wales following the UK Chancellor’s announcement of £750 million for frontline charities affected by the coronavirus outbreak, it is now essential that the Welsh Government should give hospices in Wales every penny of the funding they receive from the UK Government in consequence of the funding it has given to hospices in England.

Welsh Government funding for hospices as a percentage of expenditure is already lower in Wales than other UK nations - this has not changed for a decade and has been dropping in real terms.

I therefore praise our hospices for maintaining first-class services amidst this global pandemic, which has placed unprecedented pressures on them.

The UK Government announced £200 million of new money for hospices in England during the second quarter of 2020 and it is understood that the final allocation to the Welsh Government in consequence will be significantly more than £6.3 million.

However, hospices across Wales have expressed concern that this additional money will not be used by the Welsh Government to support and sustain essential hospice services in Wales.

This is unacceptable and as a matter of urgency the Welsh Government must speedily bring hospices out of the dark by publicly pledging that every single penny it receives in consequence of the £200 million for hospices in England reaches our hospices here in Wales.

Charitable hospices across Wales have been doubly hit by the Covid-19 pandemic with both an increase in need for end of life care and the challenge of sustaining their current service during a period where fundraising has almost completely come to a halt. Therefore, it’s high time that the Welsh Government quickly steps up to the plate.

 

Carers
 

I welcome the announcement by the Welsh Government that it will give a one-off £500 bonus to social care staff which will recognise the 64,000-odd people working in the social-care sector in Wales. We are however, still awaiting clarity and further guidance

We must also recognise the contribution of unpaid carers. At present an estimated 79% of unpaid carers in Wales are providing more care for their loved ones – with many of them picking up an additional 11 hours of unpaid care per week.

To prevent our unpaid carers from burning out, I urge the Welsh Government to provide vital levels of funding to our local authorities, to help them maintain carers’ rights and promote help available to our increasing number of unpaid champions who are feeling overwhelmed.

 

A Framework for Recovery - A plan for lifting the restrictions

The Welsh Government has published its plan for lifting the restrictions entitled "A framework for recovery".

The plan outlines seven principles which will be used to review the current restrictions, and consider options for relaxing them.

These principles will act as a framework to test the potential risk and potential benefit of relaxing some current restrictions. 

These principles include: 

  1. To what extent would easing a restriction have a negative effect on containing the virus?
  2. Is the measure at the low end of risk of further infection? 
  3. How can it be monitored and enforced? 
  4. Is it capable of being rapidly reversed if it has unintended consequences?
  5. Is it a measure of relatively high positive economic benefit? 
  6. Does it have a high impact on social and psychological well-being? 
  7. Does the measure have a high positive equality impact?

As the number of cases and deaths from Covid-19 continues to plateau and fall it is prudent to begin to plan for an easing of restrictions. However, it is essential that this is done with great care and in concert with other parts of the UK in order to prevent confusion and protect people from unnecessary risk. We must learn from experiences elsewhere, listen to the science, and work carefully through the different approaches and how they could work in practice. No matter how we move forward it is already clear that we are going to need a huge upscaling of community testing to inform any decisions and monitor the impact of any loosening of the restrictions. As a start, the Welsh Government must act immediately ramp up testing capacity by adopting the UK and Scottish Government approach to an extension of testing to all key workers and their families.