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House of Lords Hansard
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Hospitals: Patient Safety
21 May 2020
Volume 803

Question

Asked by

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To ask Her Majesty’s Government what steps they are taking to update the guidance given to hospitals about ensuring the safety of patients who do not have Covid-19 who require life-saving emergency treatment.

The Question was considered in a Virtual Proceeding via video call.

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My Lords, despite Covid-19, the day-to-day health of the nation remains the business of the NHS. That is why the NHS has issued a new operating framework to help hospitals to continue providing essential and emergency care for patients who do not have Covid-19. This guidance is being kept under review. I have placed a copy of the framework in the Library.

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Emergency admissions, of which we have seen many, though perhaps not enough, have resulted in people being very afraid of going into hospital, because there has been a lack of information for the general public. For example, what happens at the triage stage, what sort of PPE will people be wearing and how will they be protected? What can the Minister do to reassure the public that they will be safe and, on top of their emergency, will have the absolute minimum chance of getting Covid-19?

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My Lords, I acknowledge that people’s concerns have led to a decline in attendance at A&E. That is why the NHS is running an “Open for business” media campaign, encouraging all patients in need of urgent or emergency medical care to seek appropriate treatment, including, where appropriate, attendance at A&E.

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Is the Minister aware that North Cumbria Integrated Care NHS Foundation Trust has confirmed that for five weeks 100 staff working in its operating theatres had to use respiratory face masks that had not been individually fitted, putting patients and staff at risk? The regulatory-fit test had not been applied. Can the Minister look into this and check that all the other trusts in England are not making the same error?

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The noble Lord raises a question about north Cumbria, which I do not know about specifically, but I reassure him that the arrangements for PPE in hospitals have been made extremely professionally and thoroughly. Billions of items of PPE are available, and training on the fitting, wearing and changing of PPE is provided for all front-line clinical, support and other staff.

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The report recently published by the Institute for Public Policy Research, Care Fit for Carers, found that half our healthcare workers have said that their mental health has deteriorated since the Covid-19 crisis began. What supplementary provision is being put in place to deal with the mental health needs of NHS staff?

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My Lords, I acknowledge the expertise of the right reverend Prelate the Bishop of London, who, in a former life, was the Chief Nursing Officer. She raises an important point; the mental health of staff is of enormous and grave concern to the NHS, to the department and to social care. We are investing money in providing additional mental care support and are working closely with the colleges to find out how best we can provide that important support.

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My Lords, the specialist guidance on the management of non-coronavirus patients needing acute treatment, issued on 20 March, put senior decision-makers at the heart of triaging patients referred for admission. To assist them, what role would testing for Covid-19 play on admission, and what proposals are there to utilise the Nightingale hospitals as a step-down facility for Covid-19 patients, thus reducing their numbers in NHS hospitals and allowing those hospitals to deal with the backlog of cases?

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My Lords, there was some interruption in hearing my noble friend’s question but, if I understood him correctly, the answer is that all patients are now tested on entry to hospital. Until their test result has arrived, they are treated as though they have Covid-19 and isolated wherever possible.

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How will the Government enable hospitals to work on a regional basis, co-operatively, to optimise the use of surgical and radiological resources?

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I am afraid that at the moment, I cannot give a precise and thorough answer to the perceptive and very detailed question asked by the noble Baroness, but I will be glad to.

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We pay tribute to all those doing so much to help Covid-19 sufferers. However, we must not lose sight of others, such as cancer sufferers, who are being adversely affected by being afraid to go for diagnostics, having surgery and treatment cancelled, low supplies of key drugs such as painkillers, and research budgets being hit. Can the Minister reassure the public about this and tell us what he is doing to address these problems?

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The situation of cancer patients is of grave concern. We have restored all the treatments, surgery and other systems necessary for treating cancer, and we have put in place testing facilities so that those with suppressed immunity can be tested and therefore enter treatment centres with confidence. It is a situation that we maintain under review, and we are working hard to ensure that drugs and painkillers are in ready supply.

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My Lords, there are many specialist units that provide ongoing support and life-saving treatment to people with long-term, complex disabilities. Many of these units have been turned into Covid wards, for example, the National Spinal Injuries Centre at Stoke Mandeville. Will the Minister inform me when these units are likely to return to their original function? What is happening to this cohort of patients in the meantime?

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My Lords, the NHS chief executive, Sir Simon Stevens, has written to all NHS organisations signalling a change in the phasing of our response to Covid and inviting them to return operations given over to Covid to their previous use wherever possible. I hope very much that this will lower the impact on patients that the noble Baroness described. If she has a specific example in mind, I would be glad to inquire about it.

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Is the Minister aware that some NHS trusts are diverting 999 and GP emergency admission calls to hospitals other than the nearest hospital to avoid transmitting Covid between patients? Can he tell the House when that will stop? Do the new guidelines allow the Government to provide finer-resolution data on hospital admissions, which will assist understanding of optimal admission, treatment and resource allocation strategies?

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The noble Baroness speaks about infection control measures regularly undertaken by trusts. Ambulances frequently take patients not to precisely the nearest hospital but to the one best suited to treating the patient. These infection control measures have been extremely effective and will continue for the foreseeable future.

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My Lords, NHS Providers has concerns about the Government’s testing strategy for Covid-19. Will the Minister tell the House when every patient and health and care staff member with suspected Covid-19 symptoms who needs a test will consistently be able to get one within an appropriate turnaround time? When will the updated strategy be published?

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My Lords, every member of the NHS or social care employee can currently get a test when they present symptoms. They can do that through their employer, directly through the online service or a hotline. The turnaround time in 95% of tests is within 48 hours.

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There is a widespread fear of contracting Covid-19 on entering hospital, even where there are Covid and non-Covid zones. What steps can the Government take to reduce this real fear by limiting Covid patients to certain hospitals or by other measures?

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The noble Lord speaks of a fear that I recognise. It is a sad feature of our times that patients who should be in hospital are anxious about attending because of possible infection with Covid. Different trusts approach this in different ways. Some sites have been deemed Covid-free and are used for, for instance, cancer treatment, whereas larger sites manage differently, perhaps by allocating certain buildings to be Covid-free and others not. We have tried our hardest to reassure the public that they can proceed in the NHS with safety.

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My Lords, the time allowed for this Question has elapsed. We now come to the second Oral Question, from the noble Lord, Lord Teverson.