Community services are stepping up to tackle #COVID19 alongside colleagues across health and care. With @NHSProviders we established the Community Network as its national voice, chaired by @CLCHAndrew. This thread highlights some achievements and challenges. 1/16

Trusts + social enterprises offer inpatient & ‘step down’ care to free up acute hospital beds. They deliver community services in or near patients’ homes (eg health centres) to keep them well, rehabilitate after hospital discharge & support the most vulnerable. 2/16
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So their role is critical in fighting COVID-19. Media focus is often on the most urgent cases in hospitals but community teams are going to extraordinary lengths every day to support people at home. Without this, the NHS couldn’t cope. 3/16

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Freeing up 33,000 acute hospital beds has meant moving thousands of patients safely into community settings – testament to the pragmatism and skill of community teams alongside their hospital colleagues. 4/16

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If the Nightingale hospitals prove necessary, community providers will support their patients during and after treatment, as most will be used as step down facilities. 5/16

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#COVID19 pressures have also sped up collaboration between community providers, GPs and social care – remodelling the collective workforce at pace, creating hot and cold hubs in communities…6/16

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But the work has just begun. We need to keep treating COVID-19 patients and get them out of hospital ASAP. A key role for community providers in maintaining this flow of patients through the system. 7/16

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To cope with increase in workload & acuity of patients, community providers are following national guidance to prioritise resources & support staff to work differently eg AHPs enhancing discharge assessment skills, physios delivering enhanced 7-day services…8/16

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The biggest challenge is shortage of protective kit for staff. Leaders still frustrated they’re ‘not a priority’, with social enterprises only just added onto the NHS supply chain register…9/16

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…and a need to ensure primary and social care, care homes and wider community-based provision all have the protective kit they need. 10/16

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Community providers welcomed recent changes to the PPE guidance and new ‘push’ delivery system (based on expected numbers of COVID-19 patients). 11/16

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And staff are glad to have greater personal control to assess risks and decide what kit is appropriate, but lack of confidence in the supply chain still needs to be addressed. 12/16

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Not prioritising testing for community staff will be an own goal. We need to see the system as a whole and test community staff off work ASAP so we can keep managing outflow of patients from hospital. 13/16

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Data is also an issue, as the national NHS bodies focus on inpatient bed-based information which means suspected/confirmed cases in the community are harder to track. 14/16

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Finally, all NHS colleagues see the strain on our social care system. Welcomed £200m funding for hospices last week, but care home staff must get PPE and testing needed to ensure they can safely care for/admit new symptomatic residents. 15/16

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There’s much to celebrate here as community services provide a strong backbone to the NHS’ COVID-19 efforts, but key issues of PPE, testing, supporting all community settings to deal with increased acuity and support for social care need resolving. 16/16

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