Coronavirus, we are in it together

Six months ago, no one would have thought of being able to open massive intensive care units in a number of countries around the world all within a few weeks, and we certainly could not have imagined getting a virtual children's hospice up and running within three to four weeks, but we have!

As I began to think through this blog, I realised it is almost 38 years ago since I qualified as a doctor. In those years, I have witnessed many changes. From those early years as a medic working through enormous self-transformation and adapting to ludicrous hours, to working through real transformative changes in Primary Care in my post in General Practice in Kinross, and becoming CHAS's first Medical Director in 2006. But I've certainly never witnessed anything quite like the situation we find ourselves in just now.

CHAS is adapting rapidly to maintain the very best care for children across Scotland with palliative care needs, and to support their families. Traditional ways of offering short planned breaks in Rachel and Robin House cannot currently be offered other than on a prioritised basis, and this is what we have been doing, and doing it well.

We have all learnt to work by Skype or Zoom, and we are now using the "Near Me" consultations via the NHS to interact with and assess children at home, and to work with their parents, all of whom seem very comfortable with communication by this route. The virtual children's hospice is now very much up and running already delivering kindness calls; friendship calls; letter writing; Jackanory stories; virtual Clowndoctor visits; consultations with nurses, doctors and our pharmacist;with more developments in the pipeline/coming soon.. In fact, we are having even more regular contact with families than we were before this Covid-19 Pandemic, and my view is that this cannot just stop, and that we cannot 'go back to the way we were doing things' later this year... that will simply not be possible.

So, we are learning to offer a new but flexible support in a way which family members themselves can manage and we are doing this collaboratively with colleagues in the NHS and local authorities. I believe that a new normal is emerging. There are new and progressive roles for volunteers at CHAS and, going forward, this will be vital as a new even more integrated team emerges.

Working together seems to be happening by default, with up to 150 colleagues joining by Zoom to hear our newly appointed CEO Rami addressing the current situation with complete honesty and transparency, laying out the challenges as we find the way ahead. These sessions have been followed by interactive questions and answers with actions following directly from them. We have also had sessions for those on furlough who are making a real contribution to our financial future and sustainability. New Project ECHO weekly educational sessions are rapidly developing, according to need, and now 50-60 colleagues are involved in interactive but remote discussions, and we are getting used to this form of learning. Staff support systems are developing as part of this and other initiatives such as virtual chats and virtual coffee rooms are taking place across the organisation.

The houses are seeking ways of working which allow social-distancing, and many of us are having and needing to get used to wearing some form of Personal Protective Equipment (PPE). We do not know how long for, or when some of the timings for a reduction in 'lockdown' will occur, but we must remain very relevant to the care of babies, children and young people with palliative care needs, and for their families. And we are doing just that!

We're getting used to quick decision-making and to implementation of these decisions. We are learning to analyse and to evaluate contemporaneously. The speed of decisions has been required to meet the need for answers. We are proving we can rapidly move forward, and we may make some mistakes, but for me the biggest mistake would have been not to change at all. That transformation simply must be ongoing.

There are many challenges ahead for babies, children and young people, as well as their families, who we provide support for, but the response to Covid-19 is showing that we are all up for this and we are in it together for the long haul.

Many thanks to you.

Dr Pat Carragher, Medical Director to CHAS
29 April 2020