No Going Back! The story of our transformation

Holding 5,700 appointments over the phone in April – meaning fewer patients had to come to hospital 20 wards were transformed to care for Covid-19 patients at the peak of the pandemic A five-fold increase in our critical care capacity Cancer treatment and trauma care moved to nearby ‘Covid-free’ hospitals to keep patients safe and continue their treatment Psychological support for our staff in person and over the phone from a team of psychologists More than 1,000 ‘Thinking of You’ messages delivered to patients.

Covid-19 presented the greatest challenge we have ever seen in the NHS in our lifetimes. Across the country we rose to meet that challenge, and none more so than here at our Trust.

We are incredibly proud of our staff and what they achieved, together with our system partners, in an incredibly short space of time. We are also very grateful to our local communities for the incredible support they have shown us.

Here’s our story:

Almost overnight we changed the way we work across our hospitals, delivered services in completely different ways, reconfigured our estates, improved our digital capabilities, increased our critical care capacity, brought in innovative new ways of designing our workforce to meet the demands, and developed completely new approaches to training.

It has been hard and it has been relentless – and the way we have pulled together has been nothing short of extraordinary and brought so many positive changes to our hospitals. Keeping staff and patients safe drove all the decisions we made.

It’s a new NHS, a new BHRUT, and in the words our staff use to sum it up – ‘there is no going back’.

Critical care capacity was one of the key areas we knew we had to increase significantly to manage Covid-19 – we increased this five-fold and the team also managed to set up a renal dialysis unit in just 10 days! To support the critical care teams we launched a multi-disciplinary training programme for staff who have moved from areas such as Outpatients to wards, which was featured on BBC London. Some of them, like Coral, hadn’t worked on wards in many years; and theatre staff also moved from their current roles to support critical care. You can read Coral’s story and about Simon, John and Lawrie from our theatres team on our website.

We had to change the footprint of our wards so it was safe for both Covid and non-Covid patients and have had to be extremely agile to meet the changing demand and at the peak of the pandemic, had 20 dedicated Covid wards. 

Working closely together as system, with our healthcare partners and the independent sector, has been fundamental in transforming services. Our cancer patients, whose weakened immune systems mean they are more susceptible to Covid-19, have been able to continue their treatments at nearby ‘Covid free’ hospitals. Trauma care has been carried out at the Independent Treatment Centre at King George Hospital.

We developed new discharge pathways with the North East London Foundation Trust (NELFT), and worked closely with care homes and other community partners, so we move patients back into the community to receive the most appropriate care, and ensure our hospital beds were available for those patients who needed them the most. As part of this work, NELFT implemented 117 rehab beds in just 14 days!    

Three months ago our Outpatients departments were operating in ways that hadn’t changed for decades. In April and May more than 13,000 appointments were held on the phone so patients didn’t need to come into our hospitals. We also ran online ‘face-to-face’ clinics which we are continuing to expand. Plus our Physiotherapy service moved to seven days a week.

We were delighted that Magda Smith, our Chief Medical Officer, and our Divisional Director for Anaesthetics Tomas Gervais, featured on BBC Radio 4’s World This Weekend to talk about how we’ve been managing our hospitals – listen to Magda’s first interview setting out the scene early on in the pandemic and listen to Magda and Tomas’ joint interview reflecting on how things were going a bit later on.

Improving the way we use digital technology has also meant virtual meetings are now business as usual, helping us to manage social distancing, and we have been able to support many of our staff members to work from home.

Other staff members were redeployed into new roles, from Finance teams managing our front desks, to Callum in our Education Centre delivering stock to our ward areas to help support our clinical staff. Read more about Callum’s story, including how he went from a desk job to walking 20,000 steps a day!

And we also recruited new people as temporary healthcare assistants. These include Kate, a former patient and long term volunteer whose life we saved when she was treated for a brain tumour in 2016, and Chris, who has come back to the NHS after stopping his nursing qualification ten years ago due to a stroke.

We know it’s been hard for our patients and their families with very strict visiting restrictions in place. Alongside the many donations of iPads to help families and their loved ones stay on touch, we launched our Thinking of you service so people could send in messages and photos. We received more than 1,000 in the first week and have since extended it for people to be able to send in messages to patients who are in hospital and do not have any family.  

Everything we have achieved has been down to the dedication and commitment of our staff and we know the huge impact this is having on them. Looking after them has been, and continues to be, one of our key priorities throughout the pandemic. We have put in place a package of support, from wellbeing rooms to take a well-earned rest and wobble rooms to help relieve any anxieties, through to drop-in coaching and online yoga. We also launched our Listen Hear psychology service for staff to call or see our professionally trained team face to face. It’s also hard on family members who may be feeling anxious with their loved ones treating patients in our hospitals, so Joe Fielder, our Chair, and Tony Chambers, our Chief Executive, sent them a letter to thank them for their support.

Last but not least, a thank you to our residents. Your support has been invaluable and thanks to your generosity, our charity have had a great time delivering more than 100,000 portions of food and drink, sofas to our wellbeing rooms, and more than 12,500 Easter eggs!

Our journey will continue as we learn to live with covid over the coming months. We will keep you updated on the changes we make to ensure we keep you safe. And if you watch our latest video, our staff will tell you why there is no going back!