Resilience

According to the Collins dictionary, ‘People and things that are resilient are able to recover easily and quickly from unpleasant or damaging events.’

From the start of the pandemic and throughout, the Health Board was resilient in its nature, adapting services across its sites and within the community to continually provide patient care in a safe manner. The resilient approach was quickly put in place due to the pandemic, an event you can easily describe as unpleasant and damaging.

For example, back in March 2020 when the World Health Organization describes COVID-19 as a pandemic and the Health Board was preparing for the first ‘peak’ of cases, we knew we had to swiftly adopt a new way of working within our hospitals. This led to us introducing ‘zones’ to both our UHW and UHL sites, categorising the areas from ‘Green’ zones which were for patients free of COVID-19 to ‘Red’  zones which were occupied with confirmed cases of COVID-19. Working with teams from the Health Board, we made sure that these ‘zones’ had dedicated entrances and exits, with staff only working within their assigned zones to mitigate cross-infection.

On 13 March 2020, when Minister for Health and Social Services Vaughan Gething announced the suspension of certain NHS services including non-urgent surgical admissions, procedures and outpatient appointments, the Health Board’s focus was to prioritise emergency surgery and treatments. All urgent surgery was agreed to be delivered within protected units inside the green zones on our sites, with a total of 5,376 procedures taking place from June 2020 to February 2021. 

As part of our approach to keep services within the community and away from the hospital, 92% of emergency eye care problems were treated in the Cardiff and Vale communities, reducing the need for patients to attend eye casualty at University Hospital of Wales (UHW). This was thanks to a scheme by our Optometry Advisor, Sharon Beatty. 

A main part of fighting the virus was adapting our services to allow for social distancing, which caused us to rethink the way patients could access emergency treatment. As a result, we launched Wales’ first ‘Phone First’ system, CAV 24/7 in August 2020. If patients believe they need to visit the Emergency Unit but it’s not life or limb threatening, then they must call CAV 24/7 on 0300 10 20 247. They’re given a timeslot to attend the Unit so they aren’t just turning up and congregating in the waiting area, keeping themselves and our staff safe. 

Shortly after, as we celebrated Organ Donation Week in September, we reflected on the safety measures we put in place for our transplant patients to help minimise the risk of infection when they visited us in the hospital or when they were at home. However, a second spike in COVID-19 cases was looming so the Health Board acted fast to ensure a temporary facility was constructed to accommodate sufficient surge capacity, thanks to a £33m investment from Welsh Government. 150 days after constructed first started on 12th September, the Lakeside Wing was officially handed over to the Health Board from the main contractors, Darwin Group Ltd on
Monday 8 February. The Wing is currently being used as a ‘step-down’ facility for patients undergoing essential rehabilitation after a period of acute illness, which may not necessarily be Covid-19.

However, we quickly realised that we needed extra capacity, which is why we collaborated with Spire Hospital. The hospital allowed urgent surgery procedures to take place, with 10,074 cancer surgeries and other urgent procedures completed (as of 31/12/20), and over 1,500 patients receiving sight-saving treatment as part of this landmark partnership. 

As we approached Summer and case numbers started to fall, figures from Welsh Government showed a worrying 75% drop in referrals of patients with suspected cancers, as patient activity was down by ¼ in GP surgeries. With the help of our GPs, we highlighted how GP practices were #StillHereForYou as they adapted different ways of working including video, telephone or email consultations which they used to help monitor patients who have a chronic disease. We reassured parents that it was safe to bring their children in for vaccinations as practices adopted PPE and socially distant measures. With a rise in domestic and child abuse claims, and the Identification and Referral to Improve Safety (IRIS) service reaching 1,000 referrals in Cardiff and the Vale of Glamorgan, we reminded our residents that your local GP practice could signpost you to help and advice.

Our Dental Advisor, Mick Allen, explained how dental practices had to suspend routine services to limit the face-to-face contact with patients and to reduce patient travel to practices. Although they first prioritised emergency treatments, practices are slowly restarting services that had to be initially suspended (depending on the size of the clinic and how many patients are registered with them). 

Community Pharmacies also altered their ways of working, opening for extended services and some even offering oral contraception without the need for an appointment.

As we look back on the innovative solutions and resolve that our staff and systems have quickly implemented over the last 12 months in such unsettling and devastating conditions, we can safely say we are the definition of resilience.  

We have been resilient this past year, we continue to be resilient as we await what happens next in the aftermath of COVID-19 and will forever be resilient as we take the lessons learnt from this pandemic and know we can endure anything if we work together and support one another.