Author: Jade Quartermaine

The NHS Nightingale Exeter (Nightingale) was initially part of the national response to the first wave of the pandemic, providing emergency in-patient care for nearly 250 patients with COVID-19 from across Devon, Somerset and Dorset.

As a result of a clinically led redesign programme, the Nightingale is now able to offer a range of orthopaedic, ophthalmology, diagnostic and rheumatology services to local people, helping to further reduce waiting times.

After being decommissioned as a COVID-19 hospital in March 2021, the Nightingale was purchased by the Royal Devon University Healthcare NHS Foundation Trust on behalf of NHS organisations across Devon and the South West region. The site has since been used to provide thousands of important diagnostic scans to local people and support the delivery of COVID-19 vaccine studies, as well as acting as a training centre to support new staff arriving from overseas.

In May 2021, it was announced that the Nightingale would receive a share of funding from the National Accelerator Systems Programme, which was awarded to Devon to support the reduction in waiting times.

The Nightingale site has now been transformed into a state-of-the-art facility and is home to the following services:

  • Southwest Ambulatory Orthopaedic Centre, which has two operating theatres for day case and short stay elective orthopaedic procedures
  • Centre of Excellence for Eyes, which operates diagnostic screening services for ophthalmology patients and will run a high-volume cataract treatment hub
  • Devon Diagnostic Centre, which is providing CT, MRI, X-ray, ultrasound, echocardiograms and fluoroscopy services
  • The RD&E’s Rheumatology department which provides outpatient care and day case infusions.

Dr Andrew Davis, Associate Medical Director for the Nightingale Hospital Exeter and a Consultant Gastroenterologist at Northern Devon Healthcare NHS Trust (NDHT) said: “Waiting times for NHS services have increased significantly since the start of the COVID-19 pandemic across Devon and the rest of the country.

“Ophthalmology, orthopaedic and diagnostic testing services have been particularly impacted, and so many of our patients are waiting longer for treatment now than before the pandemic. We know that for many, this is having a huge impact on their and their family’s lives.

“To support these patients the best we can, we have developed a range of innovative services at the Nightingale which will help us to make a real difference to the lives of people living across the South West.”

Paul White, from Fremington in North Devon, was the first patient to receive a hip replacement at the Nightingale. He said: “I’ve had an issue with my leg for the last 20 years or so – after seeing a doctor initially, I spent a year waiting to see a specialist consultant at NDHT and was put on a waiting list for surgery.

“Compared to many, I know I’m very lucky, as I was only on a waiting list for 6 months. But this surgery will change my life – I’m only 66 years old, and thanks to my hip replacement, my body will be able to act the age I feel. I am looking forward to being able to work as a taxi driver pain free for the first time in two decades, but most importantly, I can’t wait to get back on my push bike!

“I’d like to say a huge thank you to the teams who performed my surgery and looked after me. I realise how lucky I am to get the operation. You’ve all given me a new lease of life – from the bottom of my heart, thank you so much.”

Chris Tidman, Deputy Chief Executive of the RD&E and NDHT said: “Over the last two years, the Nightingale has been an invaluable resource for the people of Devon and the wider South West region, and we are delighted that the Nightingale’s legacy of outstanding care will now continue.

“We know how difficult postponing surgery can be for our patients and their loved ones, and so as well as providing protected elective capacity to reduce our waiting lists, the Nightingale also gives us the opportunity to try things that are a bit different, often with the use of digital technology. For example, the majority of patients who receive a hip or knee replacement at the Nightingale can expect to go home the same day of their operation.

“To ensure we get the maximum benefit from this fantastic facility, we are continuing to recruit passionate and enthusiastic staff from right across the country to be part of the Nightingale’s story.’

NHS Devon Clinical Commissioning Group Director, In Hospital Commissioning, John Finn said: “NHS Nightingale Hospital Exeter has been an incredible facility supporting the NHS in the Southwest, not only for Covid-19 patients from across the region earlier in the pandemic, but also for hundreds of patients taking part in Covid-19 vaccination trials, training nurses joining the NHS from overseas and providing thousands of diagnostic scans.

“The additional orthopaedic theatres, ophthalmology centre and diagnostic scans provided there now are among a range of measures the NHS in Devon is rolling out to address the backlog of appointments caused by the pandemic.”

  • The NHS in Devon is reminding people how to access health services and get the care they need this Easter bank holiday weekend
  • Most GP practices will be closed on Good Friday and bank holiday Monday
  • For urgent advice, people are advised to ‘Think 111 First’ and contact NHS 111 for advice over the long weekend
  • Contacting 111 by phone or online, will mean advisors can direct people to the most appropriate local service for their needs

With Easter fast approaching, Devon’s NHS leaders are calling on people to be prepared ahead of the bank holidays and the two-week school holiday period.

The long Easter weekend traditionally puts extra pressure on health services when most GP practices are closed and more people are outdoors enjoying everything Devon has to offer.

Most GP practices will be closed for Easter for four days from Friday 15 April to Monday 18 April, with normal opening hours resuming on Tuesday.

Each Easter sees many patients calling the NHS 111 helpline because they have run out of medication, leading to unnecessary worry for themselves and increasing pressure on busy urgent care and out-of-hours NHS services.

Dr Paul Johnson, Medical Director for NHS Devon Clinical Commissioning Group, said: “Please be prepared this Easter to check that you have enough of your prescription medication to get you through the long weekend and any trips away that you may be planning.

“We want to ensure people are able to enjoy their trips and the Easter break without having to spend time worrying about how to access medical care if they need it.

“The NHS is here if you need us. Contacting 111 first will get you the right treatment, more quickly. You can access the most appropriate care and advice more quickly and conveniently by calling 111 or visiting 111.nhs.uk, at any time of day or night.”

People are being reminded that if they need to speak to their GP while away from home over the holidays, that they can contact their practice for an online consultation and advice during practice opening hours. This advice also applies to visitors travelling to Devon.  All GP practices now offer remote consultations, either online or by telephone, and can be contacted for advice when away from home.

For urgent advice, the message is to ‘Think 111 first’. NHS 111 can be contacted from anywhere by phone or online, at any time of day or night.

If you need further care or medication, NHS 111 advisors will direct you to the most appropriate service. They can also book appointments and check opening times for your nearest Minor Injury Unit or Urgent Treatment Centre.

If you need emergency care, NHS 111 advisors will arrange for you to be seen at a local Emergency Department. They will ensure that staff in the department are expecting you and will see you as quickly as possible.

To find out more information on which pharmacies are open over Easter click here.

  • All 5-11s now eligible for the Covid-19 vaccination
  • Booked and walk-in appointments are available from 5 April
  • Bookings open on 2 April

All children aged five and over are eligible to have the COVID-19 vaccination from 5 April.

Bookings can be made online or by calling 119 from 2 April. The vaccination is not being given to this age group in school. Walk-in and pop-up clinics are advertised on NHS England’s site finder here, but please check that the clinic is offering vaccinations to this age group.

Having the COVID-19 vaccine reduces the likelihood of further disruption to their education, developing Long Covid and passing the infection onto vulnerable family members and friends.

For most children COVID-19 is a mild illness that may require a few days off school but rarely leads to complications. For a very few children, the symptoms may be more serious or last longer.

The charity Long Covid Kids represents and supports children and young people living with Long Covid and related illnesses and their parents and caregivers.

CEO Sammie McFarland said: “The best way for children and young people to avoid Long Covid is to avoid the initial infection.

“Vaccination reduces the likelihood of contracting COVID-19 and it may provide some protection from developing Long Covid, which has been debilitating for the children and young people who access our support services.  Long Covid Kids supports a layered approach to COVID-19 protections and we are pleased to see vaccination now offered to this age group.”

While the current Omicron variant appears to be mild in most children, scientists are researching whether the variant causes a higher proportion of children to be hospitalised.

In line with recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) children will be offered the Pfizer COVID-19 vaccine. Each vaccine is a third of the dose of the vaccine that is given to older children and adults.  Most children will be offered two doses of vaccine 12 weeks apart.

Children who are at greater risk of serious illness if they catch COVID-19, such as those who have a learning disability, weakened immune system, Down’s Syndrome, severe neurodisabilities or a long-term serious condition, will need two doses of vaccine, eight weeks apart.

NHS Devon Clinical Commissioning Group’s Chief Nurse, Darryn Allcorn, said: “The Easter holiday is the perfect time to get your children vaccinated. By the time they leave school, they will have been offered vaccinations for around 18 different diseases. This COVID-19 jab adds to the vaccinations offered by the NHS to help keep them safe and well.

“It’s also not too late for others who haven’t yet had their jabs, including children who were previously offered the vaccination due to a health condition, older brothers and sisters and mums and dads.”

Like all medicines, vaccines can cause side effects. Most of these are mild and short-term and not everyone gets them. The very common side effects should only last a day or two and include a sore arm, tiredness, headache or mild flu like symptoms

If your child has any of these symptoms, they should rest and, if they are at school, they may need to take a day or two off.

You can give them paracetamol (follow the children’s dose advice in the packaging) to help make them feel better. More information on paracetamol for children is available.

Although feeling feverish is not uncommon for two to three days, a high temperature is unusual and may indicate that your child has COVID-19 or another infection.

Symptoms following vaccination normally last less than a week. If your child’s symptoms seem to get worse or if you are concerned, you can call NHS 111.

  • Masks still required in healthcare settings to protect patients and staff
  • High demand for emergency care and 200+ Covid patients in local hospitals
  • People urged to choose the right service for their needs to reduce NHS pressure

“Please don’t visit friends and family in our hospitals if you have Covid or other illnesses” – that’s the message from Devon’s NHS, as the number of people in hospital with Covid-19 remains high.

Many of the restrictions brought in to reduce the spread of Covid-19 in the community have come to an end, but people are still required to wear a mask in health settings and are being asked to wash and sanitise their hands.

And anyone with symptoms of Covid-19 or other illnesses that can spread easily, such as flu or norovirus, is urged not to visit patients in hospital.

Hospital trusts in Devon, Plymouth and Torbay are continuing to maintain enhanced infection prevention and control measures to prevent the spread of Covid-19 and health bosses are asking the public to play their part. The continued high level of infection in the community means patients are at risk of catching Covid-19 from visitors.

Dr Paul Johnson, NHS Devon Clinical Commissioning Group Chair and Devon Medical Director said: “Many of our patients are very vulnerable to infection and we need to keep them safe. If you are unwell with Covid, flu or norovirus please do not come into hospital.

“You are still required to wear a mask in health settings and we ask that you respect these rules and are patient with our volunteers and staff if they ask you to comply with them.

“We know visits from friends and family can play a role in helping patients recover so we want to maintain good access for visitors – but we need local people to do their bit by staying away if they are ill, and taking safety measures if they visit.”

Currently over 200 people are in hospital in Devon with Covid-19, which means that beds aren’t available for other patients who need them. For each Covid-19 inpatient the NHS in Devon postpones, on average, eight planned procedures.

Where possible, patients should attend appointments alone. People who want to visit a friend or family member in hospital should check the trust’s website for the latest visitor guidance.

As it continues to experience high demand in hospital Emergency Departments (ED), the NHS is also asking people to choose the right service for their needs:

  • Keep the Emergency Department (Accident and Emergency) for emergencies. If your condition is not an emergency, choose a different service. You may have to wait a bit longer for treatment if it isn’t urgent.
  • Use your local pharmacist for minor conditions such as insect bites, ear ache, skin rashes.
  • Use the HANDi paediatric app for advice on common childhood illnesses
  • Use NHS 111 – online or by phone if you need advice or medical treatment quickly and can’t wait to see your GP. If you need to be seen by a Minor Injuries or Emergency Department they can book you in.
  • Get vaccinated against Covid
  • Covid-19 is still very much here so continue to maintain good hygiene, especially hand hygiene, to reduce the spread of Covid-19.
  • Collect friends or family members from hospital as soon as possible when they are ready to leave. It means their bed can be given to the next person who needs it.

The NHS in Devon has announced the launch of a new health and wellbeing app library for local people, powered by the Organisation for the Review of Care and Health Apps (ORCHA).

Effectively a comparison website, the localised site for Devon allows patients and healthcare professionals to search and download from a wide range of apps, making it quicker and easier for people across Devon to access safe and accredited health and wellbeing applications on their computer or smart phone.

Founded by NHS clinicians, ORCHA is used widely for health application evaluation and distribution.

Healthcare professionals and patients across the country are actively engaging with the ORCHA apps library to support mental wellbeing, healthy living, and long-term condition management.

Patients are being reassured that the apps library has not been created to replace any health services, but rather to complement them.  Examples of apps within the library and how they can be used include:

  • An app for monitoring sleep patterns – a patient may be due to see their GP to discuss a sleeping issue and could utilise an app to monitor their sleeping patterns. The app may even record those patterns, which can then be shared with the GP during their consultation to help with diagnosis.
  • Quit smoking apps – there are plenty of helpful no smoking apps which patients can take advantage of to find the right support for yourself and others.
  • Mental health apps for young people chosen by young people to support through tough times.

Part of the NHS Innovation Accelerator Programme, ORCHA provides services to the NHS across many regions of the UK, providing app libraries and professional recommendation tools across a broad range of settings. The NHS Innovation Accelerator (NIA) supports organisations to scale promising innovations across England’s NHS for greater patient and staff benefit.

ORCHA also runs national health app accreditation schemes to national bodies worldwide.

ORCHA’s unique review engine tests apps against 350 criteria across clinical and professional assurance, data and privacy, usability, and accessibility.  It reviews around 500 apps every month, including automatic re-reviews of apps when they are updated.

Cases of COVID-19 are at their highest in Devon this month since the pandemic began, leading health experts to renew their calls urging pregnant women to have their vaccine.

Pregnant women with COVID-19 have a higher risk of intensive care admission, however research by the UK Obstetric Surveillance System found that no fully vaccinated pregnant women were admitted to intensive care with COVID-19 in England between February and the end of September last year. During the same time period at least 55,000 pregnant women had received one or more doses in the UK.

NHS Devon’s deputy chief nurse Susan Masters said: “The Omicron variant may be milder than previous variants, but it still poses a serious risk to pregnant women and their unborn babies. Having the COVID-19 vaccine when pregnant will protect you and your baby from the virus.

“Your GP or midwife will be happy to answer any questions or concerns.  You can also ask questions at your vaccine appointment and make yourself known to a marshal if you are finding it difficult to stand for a long while.”

Meanwhile a Plymouth teacher who was hospitalised whilst pregnant with flu, shortly after catching COVID-19, is also appealing to pregnant women to have both the flu and COVID-19 vaccinations. Christine believes that having the jabs helped to prevent her from becoming more seriously ill.

“It was really horrible,” she said. “I became severely dehydrated. My baby wasn’t getting the reserves it needed and the midwives became very concerned. It was all a bit scary, especially when there were no foetal movements for 24 hours and my temperature wasn’t coming down.

“Thankfully I’ve recovered and my baby is okay, but I certainly never want to experience that again.

“My advice to anyone would be to get every vaccine you can. Especially if you’re pregnant, it makes sense to take anything and everything you are offered to protect both you and your baby. They wouldn’t be offered if they weren’t safe for both of you.”

The Joint Committee on Vaccination and Immunisation (JCVI) recently announced that pregnant women should be considered a clinical risk group and is calling on all pregnant women to get vaccinated as soon as possible.

Professor Wei Shen Lim, Chair of JCVI COVID-19 Immunisation, said: “There is no evidence to suggest that COVID-19 vaccines used in pregnancy increase the risk of miscarriage, stillbirths, congenital abnormalities or birth complications.

“Women who are pregnant are strongly encouraged to have a first, second or booster vaccine dose as appropriate in order to better protect yourself and your baby from any serious consequences from COVID-19.”

The risk of serious complications from COVID-19 is low but a study of more than 340,000 births in England by the National Maternal and Perinatal Outcomes Audit found:

  • Women who tested positive for COVID-19 around the time of birth were twice as likely to have a stillbirth (8.5 in every 1000 births, compared with 3.4 in every 1000 births)
  • The rate of premature birth was twice as high when the mother had COVID-19 at the time of birth (12% compared with 5.8%)
  • Women who tested positive for COVID-19 were more likely to have an emergency caesarean birth compared with those who didn’t have COVID-19 at birth (27.6% compared to 18.5%)

Where can I find out more?

 

Patients across Devon are being reminded that most GP practices will be closed over the festive and New Year period and that if they need medical advice to make use of alternative services such as 111.

Most GP practices will close at the end of the day on Friday 24 December and will re-open again on Wednesday 29 December until Friday 31 December. They will then be closed again from Saturday 1 January until Monday 3 January due the New Year bank holiday.

The NHS in Devon is asking people to do what they can to prevent themselves becoming unwell and to choose the right NHS service for their needs if they need help over the Christmas and New Year holidays.

Dr Alex Degan, NHS Devon’s Primary Care Medical Director, said: “Most GP practices will be closed over the Christmas and New Year bank holidays, but there is support available from other NHS services.

“Whether you need over the counter medicines, a prescription or whether you just need to seek advice on mental or physical health conditions, there are a number of alternative NHS services available”.

If it’s not an emergency or life-threatening condition, help the NHS to help you by choosing the right service for your needs:

  • Call 111 or click on NHS 111 if you’re feeling unwell, not sure where to go or if you need health advice and guidance in non-life-threatening emergencies – available 24 hours a day, 7 days a week.
  • Consider self-care, which is the best choice to treat minor illnesses and injuries like a coughs, colds, grazes, small cuts or a sore throat.
  • Look after yourself at home and keep a well-stocked cabinet of over-the-counter medicines like paracetamol or indigestion relief available from your local pharmacy.
  • Remember pharmacists advise and treat illnesses like diarrhoea, earache, painful cough, sticky eye, teething and rashes – and by visiting your pharmacy you can avoid an unnecessary trip to your GP or A&E and save time. Find your nearest pharmacy opening times here: england.nhs.uk/south/info-professional/pharm-info/pharmacy-opening-hours/.
  • Minor Injury Units (MIU), walk-in centres (WIC) and urgent treatment centres (UTC) provide non-urgent services for things like cuts, sprains, strain, bruises, itchy rashes, stings and minor burns. For MIU locations and opening times, visit the NHS website or use 111.
  • Download the NHS App – a simple and secure way for people to access a range of NHS services on their smartphone or table. Available to download from Google Play or AppStore. Its services include:
    • Checking symptoms
    • Booking GP appointments
    • Ordering repeat prescriptions
  • The HANDi paediatric apphas been developed by paediatric consultants for parents and provides access to home care plans, as well as GP and hospital clinical guidelines, for the most common childhood health care conditions.
  • Mental health crisis cafés, also known as The Moorings @ Devon, offer out-of-hours mental health support to anyone aged 16+ in Devon, from locations in Barnstaple, Exeter, and Torquay. Click mhm.org.uk/the-moorings-devon for contact details and opening hours.
  • Get boosted, To book your COVID booster visit the National Booking Service – NHS Digital
  • To find a walk-in COVID vaccination site click here Find a walk-in coronavirus (COVID-19) vaccination site – NHS (www.nhs.uk)
  • If you have COVID symptoms you can book a free PCR test here Get a free PCR test to check if you have coronavirus (COVID-19) – GOV.UK (www.gov.uk)

There is also a wealth of self-help health information on the NHS website – www.nhs.uk – including reliable guidance on managing common winter illnesses.

Following the Government’s call to accelerate the Covid-19 booster vaccination programme, Devon’s GP practices have, at very short notice, reallocated much of their workforce to delivering Covid-19 vaccines over the next two weeks.

This means that GP practices will focus on urgent clinical need and vaccines, and some non-urgent appointments may be postponed until the New Year.

The Prime Minister, together with the NHS, has launched an urgent national appeal calling for people to get jabbed. It comes as the UK Chief Medical Officers have increased the UK Covid Alert Level from Level 3 to Level 4 due to a rapid increase in cases of the Omicron variant.

Recent data suggests that vaccine efficacy against symptomatic infection is substantially reduced against Omicron with just two doses, but a third dose boosts protection back up to over 70%.

Daily vaccinations across Devon will be doubling in the run up to Christmas with the ask of increasing the average number of weekly vaccinations given from 55,000 to 112,000 – this is a huge task at short notice and people in Devon are being thanked for their patience while arrangements to increase capacity are made.

NHS Devon’s clinical chair Dr Paul Johnson said: “Our vaccination teams are rising to the challenge, working flat out to deliver life-saving vaccines and ensure the NHS is not overwhelmed this winter with an influx of Omicron cases.

“We know this is a huge ask at short notice to double our weekly vaccinations and we thank all those across Devon for their patience while arrangements to increase capacity are made.”

Patients in Devon should continue to contact their GP practice for urgent health advice, but are urged to consider calling in the new year if it can wait, or if they can get help from another service such as a pharmacy, to allow teams to prioritise delivery of the vaccination programme.

Dr Johnson added: “We are asking for people to be patient, as GPs implement these changes as soon as practicably possible.

“Cancer checks will continue to be prioritised. People who are concerned about symptoms which could be cancer should continue to contact their GP. This could include a new lump, blood in wee or poo, or a condition that isn’t getting any better.”

People will be seen in person if they need to be examined, but most conditions can be discussed by phone, or by video call with a clinician.

The HANDi paediatric app has been developed by paediatric consultants for parents and provides access to home care plans, as well as GP and hospital clinical guidelines, for the most common childhood health care conditions.

There is also a wealth of self-help health information on the NHS website – www.nhs.uk – including reliable guidance on managing common winter illnesses.

Most GP practices in Devon are open until Christmas Eve, and re-open again on Wednesday 29 December.

People in Devon are also being reminded to come prepared for a possible wait when they arrive at vaccination centres.  They should bring warm clothes and refreshments, anything that helps while waiting.