WHSCT to reset to near pre-COVID service as Derry hospital total falls to six

Geraldine McKay, Director of Acute Services, said the Trust now aims to reset services to a level more recognisable to how they were before COVID-19. While 26 people have tragically died in Trust hospitals after contracting SARS-CoV-2, the first wave of the virus in Derry has not been as severe as was anticipated, she said.

“At this point in time we are aiming to reset and return to our services because obviously we haven’t had the surge that we expected across the Western Trust area. That is mainly down to the population doing exactly as we asked them,” she said.

“I can tell you today that across our Trust we have low numbers of positive patients in our facilities. This morning we have six in Altnagelvin and three at South West Acute Hospital which is a huge reduction from where we started,” added Mrs. McKay.

From the beginning of the outbreak the Trust’s primary focus was on developing a surge plan. Mrs. McKay said this involved significantly ramping up critical care capacity at both acute hospitals.

“We created a plan that gave us 24 critical care spaces for COVID positive cases in Altnagelvin and then 10 in SWAH.

“We zoned our hospitals into non-COVID and COVID pathways right from the front door to wards. We implemented a phased approach based on activity.

“We created capacity for, in Altnagelvin, 290 beds for COVID positive patients and 131 beds for non-COVID patients and in SWAH we created capacity for 76 COVID patients and 101 for non-COVID patients.”

The anticipated surge did not come and critical care capacity was not severely tested.

Mrs. McKay explained that there are normally ten Intensive Care Unit (ICU) beds at Altnagelvin and six at SWAH which can be immediately increased to 13 in Derry and 10 in Enniskillen. During the peak in April, capacity at Altnagelvin was further increased to 24 by standing down surgery and converting theatres for treating seriously ill COVID-19 patients.

“That’s the maximum we can go to. To be clear we never had to. We have it there.

“We have the ventilators in place. We have all of that but we never needed to. The highest we had at Altnagelvin at any point in time were seven and in SWAH the highest at any time was five,” said Mrs. McKay.

Dr. Bob Brown, Executive Director of Nursing and Primary Care and Older People’s services, was unable to provide details on the number of deaths that have occurred in local care homes as this data is validated by the Regulation and Quality Improvement Authority (RQIA).

But Dr. Brown indicated that local care homes, like the local hospital system, had not been as badly affected as had been feared.

He said: “If we call this the first surge all the regional modelling for COVID outbreaks in care homes was predicted ona worst case scenario of May into June 90 per cent of homes being affected and at this stage we are nowhere near that thankfully.”

Dr. Brown said that support was provided to some care homes with clusters of cases.

“We need to see this through May/June I believe and hopefully move from where the risk is to mitigating those risks to then building resilience because if there is a second surge of COVID in the autumn then we want to not only learn but be ready for it.”

Dr. Brown pointed out that the Trust runs five residential facilities in the northern sector of the health authority as well as working with around 60 independent providers of nursing care and residential care. The Trust partners with various hostel and supported-living providers too.

“When we look across the region for all our care homes there are 107 homes as of Friday in an outbreak situation of which there are 11 in the Western Trust.

“So that has been steady for around about a fortnight, one or two above or one or two below,” said Dr. Brown.