From desk top planning to real life – how council nurses have supported Dudley’s care homes during the pandemic…

Meet Barry Jones. Born in Dudley. Lives in Dudley. Works in Dudley as head of health protection within the council’s Public Heath Team. He’s as passionate about his work as he is about Dudley. And he’s right on the front line. “I’m a nurse who does emergency planning and infectious diseases. My role is to try and protect the population from risks,” says Barry. He has focused on where the risks are greatest – that’s in Dudley’s ninety-five care homes, most of which are for the elderly.

This is the first weekend he, and his small team of nurses, have had off for three months. This is a man who doesn’t switch off easily, especially now with the pandemic. “It’s partly my emergency planning remit – if it’s too hot I will be thinking of heatwave planning, if I’m out by the river I’ll be thinking about the flood level,” says Barry.

Testing the emergency plans – a desk top pandemic

 Barry and his team tested Dudley’s emergency plans last November when he convened a desk top exercise with partners. The scenario: a global pandemic involving a virus from China. Yes, really! Everyone that needed to be there took part; NHS, voluntary sector, police, hospitals, other managers, councillors; the list goes on. Organisations learned a lot about each other, they put faces to names.

The exercise helped Barry and the wider team understand how to respond to a pandemic and prepared them for the ‘real thing’.

Barry is convinced the exercise made a difference. He has an unswerving conviction that everyone has “given their all” during the pandemic. He talks about “the system being really strong in Dudley” – what Barry means by this is that there has been really close working by all the organisations that have a stake in Dudley’s health and reducing the risks associated with Covid-19. In Dudley, organisations are also signed up and committed to The Dudley Health Protection Co-operation Agreement, which sets out how they work together.

People wanted advice and reassurance they were doing the right things

It was Barry’s name and number that was circulated to Care Homes, schools and council teams, offering advice when the pandemic hit. First the calls were about what travel was possible, then came the calls about how to work safely and whether personal protective equipment (PPE) was needed for roles across the council such as the bin crews, social workers and schools – and what cleaning was needed and where and what products to use in different buildings.

As Barry said, “There were all sorts of operational issues people needed help with. People wanted advice and reassurance they were doing the right things.” When the calls and emails became overwhelming for Barry and his team, a dedicated Covid line was set up with more people trained up to respond.

 Not one care home had an outbreak of seasonal flu last winter

Barry and his team of four nurses focus their efforts on Dudley’s care homes. He is really proud that not one care home had an outbreak of seasonal flu last winter due to the preventative measures in place. These include pushing the uptake of the flu vaccine among residents in homes, which makes a huge difference to infection control, and encouraging the care home staff themselves to get vaccinated.

Throughout the Coronavirus pandemic Barry and his teams across the council have worked together to make sure that care homes have all the PPE supplies, if they need them. The council have been there to make sure that no home runs short. Prevention has been his priority. Barry and his nurses have been training care home and other staff in infection control procedures such as hand hygiene and how to use PPE correctly. He’s made sure that if staff feel at all unwell they must not come to work and must isolate. This can sometimes be hard in a sector when people want to care and do their jobs.

Staying in touch with care homes

 Care homes are phoned regularly, many every day. If there is an outbreak then Barry and his team are helping the care homes to manage it and limit the spread. At the worst of the pandemic Barry and his team were supporting 18 outbreaks, by early June this was down to just three. Today there are nine care homes to call. At times cases have been hard to pick up as symptoms can be hugely different, for example people can be Covid-19 positive but not have a high temperature. They can however have diarrhoea and be lethargic – again not the usual symptoms.

Working with the Black Country Clinical Commissioning Group and school nurses Barry and his team tried to ensure staff and residents in care homes got tested early – during March and April. This has been ahead of the recent Government push on testing. Barry has helped get more local testing in place near the Merry Hill Shopping Centre.

Infection rates have been the lowest in the Black Country

The preventative approach and early testing seems to be working. Infection rates have been the lowest in the Black Country – yet Dudley has a higher proportion of care home populations than the other council areas.

The tragedy we are facing now has not been seen in 100 years and whilst other pandemics involved lives being lost in the UK, what’s different this time is that the entire Country was shut down for ten weeks with the lockdown to prevent many more deaths.

We need to avoid a second wave coming this winter

Barry says, “We should expect something every ten years or so; Sars in 2003 then Swine flu in 2009, so we knew something was likely to happen.” Barry continues, “What makes this so shocking is that there’s still so much we don’t know about the virus and with no vaccine, it can still spread. That’s why social distancing is so important. What we want to avoid is a second wave coming this winter when the NHS is having to cope with seasonal flu.”

Barry hopes that now we are in the next phase with the Test and Trace regime that will help stop the spread of the infection if we can find and isolate those with the infection and their contacts.

Barry has been in nursing for many years. He started in the NHS in 1988, as a student nurse, then in Trauma and Plastics (that’s plastic surgery). He then ran a surgical ward before deciding to become involved in infection control. He moved to Dudley 2013 and has never looked back. As Barry says, “I love Dudley, I love my job, it’s a vocation. People don’t realise there are nurses working in councils but there are – and at the moment we are very much on the frontline.”

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