Agenda item

A verbal update on Covid-19 will be provided by Mr Neil Macdonald, Chief Executive of Buckinghamshire Hospitals Trust.


Neil Macdonald, Chief Executive, Buckinghamshire Healthcare Trust provided the following update:


  • A Level 4 incident was declared in the first week of March 2020 due to the coronavirus; this had never been experienced before.
  • Significant transformation had been carried out at Stoke Mandeville Hospital (SMH) and Wycombe Hospital (WH) to segregate patients into green and red zones in order to provide protection and track the infection.
  • Successful collaboration had taken place between Buckinghamshire Healthcare NHS Trust (BHT), Buckinghamshire Council (BC) and the health commissioners.
  • Approximately 95% of out-patient appointments were transferred to a virtual platform in the first two weeks of the crisis.
  • The majority of routine surgery and screening programmes had been suspended.
  • Approximately 4,000 staff had been trained in the use of personal protective equipment (PPE); the national supply chain model was providing the PPE.
  • Cancer services had been set up at the Chiltern Hospital in Great Missenden.  The cancer ward in SMH had been relocated to the Shelburne Unit at WH to protect the particularly vulnerable patients.
  • Approximately 2,500 members of staff were working from home.
  • A mental health support line had been set up in partnership with Oxford Health to deal with the increased demand for mental health services.
  • All emergency services, including maternity, had continued.
  • BHT was engaging with local businesses to supply equipment and catering.
  • The district nurse service had continued as normal and community services had played a significant role in linking in with BC colleagues and health commissioners to protect vulnerable residents and children.
  • A level of change had been achieved which would normally have taken 3-4 years.
  • The virus would be here for a while and would become the ‘new normal’; preparations would be made for a possible second wave of infection.
  • There was concern over the impact on residents’ health as attendance for the most clinically serious ‘type 1’ admissions to Accident and Emergency (A&E) had reduced by 45%.
  • The economic downturn would also impact people’s health and BHT was working with BC and partners to support the non-hospital care sector.
  • The priorities were to learn from the crisis and to shape future provision.
  • People who needed urgent care should seek help immediately.
  • A plateau had been reached and BHT was looking at safely bringing back other urgent services such cardiovascular.
  • Risk assessment and segregations would need to be carried out to ensure safety of patients before bringing back routine services and would be a regional response in collaboration with other hospitals.


The Chairman invited a number of Cabinet Members to ask questions or provide a brief update as follows:


  • In response to a query on the supply of PPE; N Macdonald explained that BHT had moved to a national PPE distribution model and overall the model had worked as the hospitals had not run out of PPE.  BHT had been well supported by local businesses which had been making PPE and schools had offered their stock.
  • A member of the cabinet asked how many patients were discharged early into care homes in order to free up beds and what would be carried out to ensure there had been no additional risk.  N Macdonald was unable to provide the exact number of people who were discharged early due to the pandemic.  The opening of Olympic Lodge had been a great success.  BHT would work in conjunction with Public Health and the clinical commissioners to track the data on the early discharges.
  • Concern was raised that the suspension of maternity services at WH could become permanent; however, N Macdonald confirmed that the ante-natal and post-natal services were continuing.  The WH birthing centre would re-open when possible.
  • A member of the cabinet commented on the amount of changes that had taken place in the hospitals and whether the collaborative work which had taken place previously had helped.  N Macdonald acknowledged that a phenomenal amount of work had been carried out by his staff of approximately 6,500; he was proud of them all as it had been a scary experience treating so many Covid-19 patients.  N Macdonald stressed that the strong public and private sector relationships had come to the fore when the crisis arose and worked extremely well; he hoped that some of the changes would be retained.  It was noted that there had been a considerable amount of partnership work in many areas.
  • The drop in ‘type 1’ A&E admissions was a concern; some people did not want to overwhelm the NHS and some people were fearful of catching the virus.  N Macdonald advised that a new segregation unit had been built at the front of SMH; everyone was screened and checked before entering the hospital and diverted via the green route (non-Covid-19) or the red route (Covid-19).  Patients were segregated throughout the hospital; this process was being considered for when routine services resumed.  N Macdonald emphasised that everyone who needed urgent care should seek help.
  • The Olympic Lodge was not being fully utilised enabling staff to be redeployed to other sectors of Adult Social Care (ASC).
  • The situation in the care homes had been receiving media attention. ASC were working closely with the care homes; webinars had been provided on infection control and the use of PPE.  PPE supplies had been obtained and testing was available which would help with staff shortages.  Approximately 30% of the care homes in Buckinghamshire were affected by the virus.
  • Approximately £65m of business grants had been provided to 5,000 businesses in Buckinghamshire.  The remaining eligible businesses were encouraged to apply online for a business grant on the Bucks Business First website.
  • There was one known rough sleeper in Buckinghamshire who had not taken up the offer of temporary accommodation.  Those in temporary accommodation had access to medication and food and did not need financial support; if members of the public wanted to help they should provide a donation to the food banks.  The aim was that the housing team would continue to manage the rough sleepers once the pandemic was over.
  • Green bin (or brown bin depending on the area) collections would recommence on Monday 11 May 2020; residents were requested to avoid over-filling the bins and extra bags/items would not be collected.  Five Household Recycling Centres were ready to open but BC was awaiting government guidance.  The sites at Amersham, Aston Clinton, Beaconsfield, Buckingham and High Wycombe would comply with the social distancing measures – opening dates would be published on the BC website when known.
  • Approximately 1800 people had volunteered to help; BC was working closely with voluntary partners to allocate resources.  A weekly funding call was held to avoid duplication; more funding was in the pipeline.
  • BC was working on recovery stage planning.  A mental health cell was working within the Voluntary Community Sector (VCS) framework and would tie-in with work being carried out by Public Health.  Tribute was paid to the volunteers who were phoning vulnerable residents, and those in social isolation, to provide support.
  • Debt and domestic violence were issues that would be focussed on.
  • Children with Educational Health Care Plans or Special Educational Needs and Disabilities were still being taken to school by the school transport providers; the transport providers were also taking children of key workers to school and helping ASC patients attend their appointments.
  • The Education Service was waiting for direction from central government on when the schools would be re-opened; information would be communicated as soon as it was available.


The Cabinet members expressed their thanks to Neil Macdonald and the NHS staff for their efforts and collaborative working.