SWL Clinical Cell Update – Edition 1

Update from Dr Andrew Murray,
Chair of the South West London Clinical Cell
Message from your clinical leaders in South West London

Dear colleagues,

We know this is a difficult time for everyone. NHS clinicians are our biggest asset to help us overcome this COVID-19 situation. This is why your clinical leaders across South West London are doing everything we can to:

  • secure the right PPE equipment for you to do your job safely
  • increase the capacity for staff testing, particularly for staff supporting critical care

This is also why it is really important you follow the national guidance for clinicians on self-isolation, to protect yourself, your patients and the wider population.

An incident control room for the NHS in South West London has been set-up to provide command, coordination and decision-making for COVID-19. South West London is Gold Command and reports directly into NHS England to support our NHS leaders to manage the incident in their organisations and across our system.

South West London must be agile and responsive to the changing nature of the virus and to the national response measures being put in place. We are also guided by experts in four ‘cells’ made up of our lead clinicians and managers across South West London. These cells are working to advise on day to day clinical challenges as well as looking ahead to the issues we will face in the coming weeks to see how we can work together to best protect our population.

These cells are:

  • The Clinical Cell – Chaired by Dr Andrew Murray, GP Chair
  • The Acute Cell Chaired by Jacqueline Totterdell, Chief Executive of St George’s University Hospitals NHS Foundation Trust
  • The Primary Care Cell – Chaired by Dr Nicola Jones, GP Chair
  • The Community Cell – Chaired by Patricia Wright, Chief Executive, Hounslow and Richmond Community Healthcare NHS Trust

This is the first update from the Clinical Cell and is for all clinicians, professionals and staff across South West London supporting our response to this new coronavirus.

Who is in the Clinical Cell?

Our Clinical Cell is made up of the medical directors from each of our NHS hospital providers, three of our GP clinical chairs, a director of public health and other leading clinicians from across our system. We’ve included the full list at the end of this email.

What is the purpose of the Clinical Cell?

As a Clinical Cell we are working together to:

  • Provide senior clinical input and advice on strategic system decisions, for example
  • Identify system clinical issues for resolution and escalating when necessary to the control room and Gold command or to either the primary, acute or community cells
  • Share learning between providers and prevent duplication

What are we focusing on?

Our current focus is on increasing our hospital capacity to deal with COVID-19 patients by:

  • Supporting vulnerable patients in the community to keep them out of hospital
  • Safely discharging patients into the community
  • Prioritising clinical work to free up our workforce for re-deployment (considering what can be stopped and how we could re-deploy)

Other areas the Clinical Cell are considering include:

How to support primary care resilience

  • Reducing outpatients and referrals
  • Intensive Care Unit capacity
  • Dissemination of clinical guidance with additional insight from our leading London clinical experts and networks
  • The Royal Free is working on an ethical framework which we will share once it is published and each organisation will work out how this fits with their own decision-making processes. In addition will be setting up an ethics panel for South West London.

This coming week, we are further focusing on:

  • Cancer, critical care, stroke, thresholds for mental health patients
  • Understanding in more detail the work of the Community Cell and the support needed for South West London’s care homes
  • Links with Local Resilience Forums to make sure they are best positioned to support the needs of vulnerable patients

Clinical Guidance

As I hope you know already, the latest clinical guidance for clinicians is hosted on the NHS England website: www.england.nhs.uk/coronavirus

We will also be sending you links to other clinical information, insight and guidance we think might be helpful to you. This one below is from King’s Critical Care, an evidence summary of the clinical management of COVID-19:

https://www.nwpgmd.nhs.uk/sites/default/files/KCC%20COVID19%20Evidence%20Summary.pdf

Playing our part in the collective response

We know we have exceptional clinicians across South West London and we are inspired every day by the way we see colleagues pulling together to care for all our patients.

We are already, individually and collectively, finding new ways to be flexible and adapt to the new ways in which we must work to do the best we can for our patients. The South West London Clinical Cell will make sure that clinicians are at the heart of decision making in South West London.

We will take advice and guidance from expert national clinicians and learn from other healthcare systems across the world. I know you will all be aware that we need to change the way we work and redeploy staff where they are most needed.

Thank you

I wanted to take this opportunity to thank you all for your hard work. It is by continuing to work together and share best practice during these unprecedented times that we will best protect our population and the people we are here to serve.

Best wishes,
Dr Andrew Murray
GP Chair NHS South West London Clinical Commissioning Group
On behalf of the South West London Clinical Leadership Cell

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