Hot Site Success for Health Bosses in COVID-19 Fight

12 May 2020 8:50am

A pioneering solution to combat the threat of coronavirus and enable the continuity of care for patients has been implemented by health bosses at Shropshire, Telford and Wrekin Clinical Commissioning Groups (CCGs).

Two ‘hot sites’ have been successfully established in both Shrewsbury and Telford town centres which pioneer innovative clinical models designed specifically to deliver COVID-19 assessments in the safest way possible.

Almost 20 patients are seen per day at the two hot site locations with patients being referred from 38 practices across the Shropshire area from 53 practices in total.

The model includes a drive-through facility for clinical consultations and assessment rooms if patients need face-to-face consultation or more clinical contact.

The ambitious project began at the end of March, with the Shrewsbury hot site first established at the Shrewsbury Town Football Club, closely followed by a second site at the Telford International Centre.

From empty car park to medical facility, the project in Shrewsbury took just three days to implement and open to patients. The Telford site, in rolling out the same model as Shrewsbury, was opened in a similar timeframe.

There are also discussions underway to further develop the service to offer home visits for patients who are house-bound.

The primary objective of the hot sites is to reduce disease transmission, and provide care to people with coronavirus, as well as those in their households. This leaves Primary Care facilities with a reduced COVID risk, protecting high risk patients and medical staff at those facilities.

Patients are seen by health professionals at the hot sites to assess the severity of their coronavirus symptoms, or to deal with other non-COVID illnesses where transmission remains a risk.

The hot site also offers blood testing and routine dressing which ensures a single point of contact is upheld, therefore significantly reducing the risk of COVID transmission.

For patients with active coronavirus who are in the high risk groups, the Coronavirus Management Service (CMS) has been commissioned to provide daily review and to arrange ongoing care as needed.

The hot sites provide normal Primary Care assessments for patients experiencing non-COVID health problems, but are in isolation. This is either because they have coronavirus themselves or they are living in a household with someone who has coronavirus and so presents an infection risk.

Dr Kieran McCormack, Clinical Lead for the Shrewsbury hot site and GP Partner at Worthen Medical Practice, Shropshire, said: “The planning stage was the major element in this project as we needed to act quickly once the virus started to emerge nationally.

“The Shropshire, Telford and Wrekin Clinical Commissioning Groups acted decisively from the offset. We have now seen in excess of 260 patients since the beginning of the project.

“Fastidious attention to PPE discipline and clinical processes has also made the site as safe an environment as possible in the circumstances.

“Having monitored the situation through the European Centre for Disease Prevention and Control (ECDC) we were able to adopt guidance very early on which has been key to our success.

“By keeping patients with COVID symptoms away from General Practices, these facilities are a safe place to assess non-COVID patients and those at high risk, arguably contributing to the low overall incidence of coronavirus in Shropshire.”

Dr Aidan Egleston, Clinical Lead for the Telford hot site and GP Partner at Wellington Road Surgery, Newport, said: “From the decision to create an assessment centre in Telford to opening to patients at the Telford International Centre, the project took just seven days to complete, thanks to the support of Dr McCormack and the established Shrewsbury site model. 

“Close collaboration with Telford and Wrekin Council, which included setup, signage, and marshalling support, also meant that we were able to mobilise extremely quickly. This help from the local authority is also ongoing which we are very grateful of.

“Although the number of patients being seen at Telford remains thankfully small, this crucial service protects our patients and staff from high risk contacts, enabling local practices to focus on other patient care safely.”

Dr John Pepper, GP Partner at Belvidere Medical Practice, Shrewsbury, Shropshire, said: “The efforts taken to create the hot sites in such a small space of time has meant that isolating COVID assessments at an early point has benefitted both our patients and the Primary Care workforce.

“We have also worked collaboratively with a number of organisations in the county to bring this project to fruition. For example, a bespoke taxi service has been set up, in partnership with the local authorities, for those patients unable to drive to the sites.

“Marshalls are also on hand to help patients navigate to the correct areas of the site and to also signal any issues that might need to be addressed; such as wheelchair access or those who need extra help.”

Steve Ellis, Head of Primary Care for Shropshire CCG, said: “The decision to set up the centres at the Shrewsbury Town Football Club and Telford International Centre was because they were separate from residential areas and away from other GP practices. The locations also provided large car parks for the split function of the model which includes drive-through and assessment rooms.

“Every decision that has been taken during the project has revolved around the safety of our patients, but also to reduce the spread of coronavirus as much as possible.

“Our clinicians say they feel safe and happy to work from the sites knowing how much work has gone into ensuring the best possible outcomes.

“It is complicated work but we have a fantastic team who have dedicated their skills and expertise to the hot sites. It is due to these staff members and the support we have received since the beginning of the project that has brought about the success we are now seeing.”