Asked by
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.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care ()
(Con)
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.
(Con)
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?
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.
(Lab)
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?
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.
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?
My Lords, I acknowledge the expertise of the right reverend
Prelate the , 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.
(Con)
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?
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.
(LD)
How will the Government enable hospitals to work on a regional
basis, co-operatively, to optimise the use of surgical and
radiological resources?
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.
(Con)
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?
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.
(CB)
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?
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.
(Lab)
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?
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.
(LD)
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?
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.
(CB)
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?
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.
