Shropshire health boss: 'Community health services are backbone of NHS'

Steve Gregory is the executive director of nursing and operations at Shropshire Community Health NHS Trust. Here he discusses how the organisation has responded to the pressures of Covid-19 and the importance of remaining vigilant:

Our staff delivering community health services has been right on the front line of the national response to Covid-19.

That is true here in Shropshire as it is in every region across the country and beyond.

In Shropshire, Telford & Wrekin, the delivery of these vital services sits with Shropshire Community Health NHS Trust.

Our staff are present in communities across the length and breadth of the county and are involved in the delivery of care from cradle to grave – and just about every point in between.

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When our name is mentioned, most people seem to think of the community hospitals in Bishop’s Castle, Bridgnorth, Ludlow and Whitchurch.

We run the inpatient services in those hospitals, and those teams have been doing a fantastic job during the coronavirus pandemic.

They have looked after some very sick people and done so with their usual compassion and their unflinching commitment to high quality care.

What you might not realise, is just how much more we also do as an organisation. The range of our services is vast.

Did you know, for example, that we have an experienced and talented safeguarding team responsible for ensuring the safety of vulnerable children and adults?

Did you know we provide health services at Her Majesty’s Prison Stoke Heath, looking after the health needs of a cohort of prisoners with a wide range of health needs?

Did you know we offer a wide range of services for children, young people and families in Shropshire and in Telford & Wrekin? That includes health visitors and school nurses.

Our reach actually extends beyond our county boundaries, as we also manage the school nursing team in Dudley, too.

Those children’s services have been severely tested in recent weeks.

They have had to ensure vital services are maintained, and do so with fewer staff as team members have been diverted, or ‘redeployed’, into other frontline teams where there is an immediate and pressing need due to our planning for the pandemic.

A number of our children’s teams have joined a newly created swabbing service.

As an organisation, we have taken responsibility for the swabbing of all NHS staff in Shropshire, Telford & Wrekin who have been showing symptoms of Covid-19.

We’ve also expanded that service to support care homes as well.

Getting that off the ground has been a mammoth undertaking, and I am so proud of the hard work of the people who have made it happen.

Our adult services have really risen to every challenge we have thrown at them.

As a local health system, we have established a new discharge to assess team, tasked with helping get patients out of hospital and into a community setting where their needs can be met.

This important work has helped to reduce the risk of those patients being exposed to the virus, and helped the acute hospitals create valuable capacity.

We have adopted at scale new ways of working, for example the use of technology to conduct patient appointments, where this is appropriate.

Meetings will never be quite the same with use of different technology, in truth we are still getting used to this. It really has been one of the big successes of recent weeks.

It will be important, once this crisis is behind us, that we are able to retain those elements that have been most effective.

There can be no going back. Right across the NHS, we have seen new ways of working introduced – changes that have maybe been considered or talked about for years that have suddenly been turned into reality.

Not that we can afford to put our feet up and congratulate ourselves just yet.

Yes, the peak of the virus may have passed, but it is still very much at large in our community. We must stay alert.

The lockdown has been effective in bringing down the rate of infection, but as we start to see the restrictions slowly eased, then so we must be vigilant to see the impact of that.

We also have to think about our plans for the forthcoming winter (it might seem odd now) to ensure we continue to cope with any increase in demand upon any of our local services.

We are expecting some schools to open from June 1, of course.

It will be a slow process – only children in reception, year 1 and year 6 at first – but it is still a new challenge.

I know how hard local schools are working to make the whole process as safe as possible.

Our children’s services will be working alongside the schools and giving them every bit of support they need.

I’m so proud of each and every one of our teams – not just those directly working with patients and service users, but our non-clinical teams, too.

I want to especially mention our communications team, who have been keeping the public up-to-date with service availability but also making sure our staff have all the information they need.

It’s a difficult but vital role that is not always appreciated.

So I want to finish with a huge thank you to all our teams.

I hope that when, finally, this is all behind us and some sense of normality has returned, there will be a recognition of the importance of community health services.

For me they are, quite simply, the backbone of the NHS.