NHS services in Nottingham and Notts have been suspended to help health workers deal with the increased pressures caused by coronavirus.
From mental health services to closing and moving treatment centres, there has been a wide range of changes.
Some of the changes have been mandatory nationally, while others have been locally organised.
A few of the services have returned with limited operation, such as home birthing.
In a statement to Nottingham City Council, due to be discussed next week (Thursday, July 16), Nottingham and Nottinghamshire Clinical Commissioning Group said: “The degree of pressure on the system and the rapid pace at which we have had to respond to protect the safety and welfare of patients and staff has meant that it has not always been possible to notify the local authority of changes that, in normal times, you would be consulted on.
“In the main, changes have been made by providers to manage workforce and operational pressures and to maintain patient safety. They have not been commissioned by the CCG.
“Over the next two weeks we will be undertaking analysis to identify which of the changes need to be reversed as soon as it is safe to do so, and which we are considering making permanent.
“The latter will include changes that have been made that are aligned to the ambitions in the NHS Long Term Plan and have made a positive impact on health outcomes.”
Dr Stephen Shortt, joint clinical leader at Nottinghamshire and Nottingham CCG, said: “The NHS has made a number of temporary changes to services across the country during the pandemic.
"Locally specific services have been altered for a number of reasons including, for example, where staffing levels are too low for a non-urgent service to continue.
"During the pandemic, we have also introduced a number of new services, for example, increasing the support provided into care homes.
"All changes made nationally and locally are to ensure patient and staff safety remains a top priority.
"We understand these alterations may have caused inconvenience and upset for patients and as we move into this next stage of the pandemic we are supporting our providers to reintroduce services as soon as it is safe to do so.
“Over the last few months we have seen many positive changes fall out of the adjustments needed due to the pandemic, such as more people attending GP appointments virtually and a greater use of NHS 111 Online.
"Many of the changes made to services were mandated nationally and some changes have been made by the local system, in response to local need.
"As a result, we are now asking for the public’s feedback on these changes through a survey so we can continue to develop and progress our services. We want to learn from the pandemic, take on board the views of local people and make sure that we continue to provide services that meet the needs of our population.
"To take part in the survey visit https://www.surveymonkey.co.uk/r/Y2K3675 between July 9– August 14.”
The full list of suspended or altered services is as follows:
Primary Care
- Introduction of Clinical Management Centres (CMCs) to allow general practice to function effectively during the COVID-19 outbreak.
- Introduction of a new GP operating model including greater use of remote working; phone and video consultations; suspension of routine non-urgent appointments
- Enhanced support to care homes from GP Practices
Urgent Care
- Development of a single discharge pathway
- Relocation of the primary care element of the Urgent Treatment Unit (UTU) at QMC to Platform One, Upper Parliament Street
- Temporary overnight closure of Newark Urgent Treatment Centre (UTC) from 10pm to 9am from April 6. A further extension has been proposed due to ongoing workforce pressures.
- NUH is developing plans to transfer hyper acute stroke services from Nottingham City Hospital to QMC, to support winter planning and infection prevention and control measures.
Mental Health
- Open access all age 24/7 crisis line set up
- Reduction or suspension of face-to-face contact and increased use of phone and video consultations and online resources for the following: Crisis Teams; Local Mental Health teams; Community Mental Health Teams; CAMHS; Kooth; Sharp; Harmless project
- Temporary use of Haven House crisis house as a step-down unit to support discharge (change now reversed)
- Recovery College services suspended and staff deployed to other areas
- CAMHS support to schools via in-reach
- Alexander House locked rehabilitation service designated as an isolation unit, with patients transferred to the Orion Unit at Highbury Hospital
Planned Care
- Block Contracts established with Independent Sector providers to create additional bed capacity
- Move from face-to-face to virtual clinics for outpatient services where appropriate
- Postponement of all non-urgent elective operations
- Suspension of community non-obstetric ultrasound service
- NUH suspended faecal sample testing
- SFH Suspension of termination of pregnancy service – service to recommence from June 9 (community service continued)
- Temporary suspension of home births service by SFHT and NUH - NUH has since re-established a restricted home births service
Children and Young People
- Integrated Community Children and Young People’s Healthcare Programme: Routine reviews of respiratory conditions delayed except for at risk patients; routine referrals delayed; therapy services delivered by video conferencing or phone.
- Out of hospital community services stopped except clinical priority services; child protection medicals; phone advice and urgent referrals
- Rainbows Childrens’ Hospice: Respite Short Breaks suspended; family support services by video and phone; adult day care suspended
Community care
- Community Orthoptics service suspended all non-essential face-to-face services and increased use of video and phone consultation
- Community diabetes nursing teams suspended clinics and education courses
- Face-to-face community rehabilitation suspended, except for patients who have had recent elective surgery; fractures or those with acute and complex needs
- Neuro rehabilitation - Chatsworth Unit patients discharged to community provision and inpatient function temporarily closed to admissions
- Community podiatry and podiatric surgery services suspended, except for high-risk patients
- Community services provided by Primary Integrated Community Services (PICS) suspended all non-essential face-to-face interventions
- Community MSK groups suspended
- Community specialist nursing service suspended
- Changes to community pain management services, including suspension of face-to-face consultations; greater use of video and phone consultations and suspension of steroid injections
