Arch's early response to Covid

A letter from Arch CEO to update our friends and supporters about our responses to Covid-19 (April 2020)

Hi Friends,

I wanted to say a huge thanks to all the friends and supporters of Arch for your kind words of encouragement and thanks to our team as we’ve tried to respond as quickly and effectively as we can to the Covid-19 outbreak. Like us, many of you have been concerned about the impact of the pandemic on people who have nowhere to self isolate because they are sleeping rough or living in accommodation which they share with others.

CHALLENGES FOR PATIENTS

As homeless services across the city have experienced staff shortages, and the government have instructed the closure of all gathering points, those who are without secure and private accommodation​ face many challenges. Living on the empty streets of Brighton & Hove without access to food, water, sanitation or shelter is very frightening indeed, even without the constant uncertainty and fear of infection.

CITY WIDE RESPONSES AND NEW ACCOMMODATION

Since early March Arch has been working alongside colleagues at Public Health, the City Council, the CCG, and all homeless services in Brighton & Hove to develop appropriate to develop appropriate accommodation for 300-400 homeless people who are either living on the streets or in accommodation with shared facilities which does not allow them to self isolate.

On March 27th the Ministry of Housing, Communities and Local Government (MHCLG) instructed all local authorities to move rough sleepers off the streets within just a few days. This announcement gave rise to a huge effort on behalf of all the partners as we tried to secure the necessary accommodation at break-neck speed. It was not without its challenges but city council have secured several facilities to be used for this purpose.

CITY WIDE RESPONSES AND NEW ACCOMMODATION

The role of the Arch team has been to help design a system of which follows the Pathway Model of:

Triage – Cohort – Protect – Care

This means that, our clinical team are TRIAGING people and checking for symptoms which may be Covid-19. Based on this assessment, patients with no symptoms are allocated to ‘PROTECT’ accommodation where others who have no symptoms are accommodated and grouped again into those who have higher and lower health risks. Those patients who are found have potential Covid-19 symptomatic are being housed in ‘CARE’ accommodation where they are able to self isolate and recover.

All residents, are checked on daily by key workers and clinicians, and monitored for any changes in their condition. Our Arch clinicians are working closely with the St Mungos team, 7 days-a week, to ensure the best possible care is offered to all. Food, medication and specialist supplies are being delivered to residents so they are able to fully self-isolate.

As you’ll imaging this has been a huge amount of work for a large number of people from many organisations. At Arch we are especially proud of our clinical team, who have advised partners, participated in many conference calls and written extensive guidance whilst continuing to provide care to our own patients back at the surgery. The CCG have support the increase of our team to generate the necessary response and we are currently working to do that.

CHANGES AT THE SURGERY

The Arch team have made many adjustments, we have had our fair share of staff sickness and self isolation due to symptoms within families. As a small team that has been extremely difficult to manage but our staff have responded magnificently and gone the extra mile on every occasion. The surgery remains open but the service is far from normal, almost all our consultations are being conducted by telephone and we have provided mobile phones to those patients who don’t have them.

We are currently still seeing patients who need a face-to-face consultation or a dressing but these are very much the exception just now. This is all the total opposite of our usual ethos which is welcoming, friendly, engaging and keen for people to be seen. We all feel rather uneasy encouraging people to stay away but we know it is necessary to keep patients and staff safe.

DAILY CONTACT
From very early in this crisis our clinical team have recorded every patient who we know is required to self-isolate due to either symptoms or circumstances, making an assessment of their needs in terms of food, medication and any specialist equipment. Patients on this list have been contacted daily by a GP or Nurse Practitioner in order for symptoms to be monitored and, where possible, the Justlife Health Engagement team have provided support with deliveries and further telephone care.

Our reflection is that so many individuals and services are working incredibly hard and pulling together to respond to this crisis. We believe in the model which which is now being delivered through collaboration and are confident it will be effective in reducing suffering and saving lives.

Thanks again for your kindness and support. We really do appreciate it. Please stay safe.
Gary Bishop, CEO, Arch Health CIC