Services turn to hotels and equipment to manage out-of-hospital care during Covid-19 pandemic

The NHS and local authority in Reading are using various strategies to keep pressure off hospitals and protect vulnerable people.

Local health and social services have revealed various ways they are managing patients outside of hospital during the coronavirus pandemic.

Some people who had been quickly discharged from hospital after general illness or surgery have been sent to the Holiday Inn on Basingstoke Road in south Reading.

Meanwhile some patients who have gone to A&E with breathing difficulties that might be linked to Covid-19, are being sent home with equipment to monitor their oxygen levels.

Reading Borough Council is paying for up to 30 hotel rooms as ‘discharge to assess’ units for people who were being discharged within two hours of the hospital deciding they were medically fit to leave. The government introduced the two-hour discharge deadline to ensure hospitals had capacity to treat seriously unwell Covid-19 patients.  

However social services need more time to arrange care packages for people due to go home, such as regular visits by carers, nurses or physios, or special beds or equipment for their homes. Some people are also having to stay in the hotel - which is closed to the general public - to protect relatives back home who may be in the vulnerable ‘shielding’ group, or self-isolating with Covid-19 symptoms.

Meanwhile, the Royal Berkshire Hospital has announced it is one of the first places in the country to adopt a system used in northern Italy.

Patients who arrive at the Emergency Department with breathing difficulties are given routine tests on their heart, blood pressure, oxygen levels and respiratory rates as usual. Doctors then decide whether the patient needs to be admitted or is suitable to be sent home with a pulse oximeter which will monitor their oxygen levels.

For about five days, clinicians will phone the patient daily as part of a robust system of keeping a check on their condition. If, at any time, they become concerned about a patient’s oxygen readings, they can be called back into the hospital for observation or treatment.

Dr Joseph Nunan, ultrasound fellow in the hospital’s acute medical unit said: "This Covid triage pathway, was shared with us by doctors from Brescia, Italy, working in what was then the second Covid hotspot in Europe. The collaboration, which has led to the Royal Berkshire Hospital adopting this Italian triage pathway, has shown the NHS and the RBH at their very best. We're keen to share our experience with other hospitals, so we have built a website:”

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