York and Scarborough Hospitals NHS Trust

We wanted to update you, that from the 31 March York and Scarborough Hospitals NHS Trust have made some key changes to their ‘Living with COVID’ IPC guidance.  This has been necessary due to the unprecedented pressures on the acute hospital sites.  We recognise that we are now operating out-with national guidance and we will keep the situation under review, for de-escalation back to national guidance as soon as we are able.  
The main changes we have instigated are:-
1)      On admission, routine swabbing of asymptomatic patients will stop except for patients who are identified as “High Risk to COVID-19” (HRC).
2)      Patients will now be placed on one of 3 pathways COVID-19, Non COVID-19 and High Risk to COVID.
3)      Any inpatient becoming symptomatic will be tested and managed according to the result, routine IP testing for asymptomatic patients will cease, except for HRC patients
4)      Asymptomatic non-HRC patients who become symptomatic and test positive for COVID-19 will be isolated (either on a COVID-19 ward or in a side room on a specialist ward if there is a clinical need). The bays these patients were located in will not be automatically closed for COVID contacts and patients in the other beds will only be tested if they subsequently become symptomatic.
5)      Discharge testing will only be conducted for patients being discharged to a partner healthcare organisation where it remains mandated.  Discharge testing will stop for patients being discharged to Trust services.
6)      Routine staff testing will stop for all staff unless they are classified as HRC or work on a HRC ward/department.  Staff with mild symptoms who are able to work will do a LFT and if negative return to work. There are no changes to the isolation guidelines for staff testing positive.
7)      There is currently no change to IPC precautions (eg. Mask wearing) in non-clinical areas.
How can you help us in the current pressures?
We have seen increasing length of stay in hospitals for patients who become a COVID case or contact whilst an inpatient with the Acute Trust.  We appreciate that there are significant workforce challenges across the care sector and understand that there are risks to discharging people who may be classed as a contact back to care homes if a patient cannot be isolated. However, we would value your support in helping us discharge as many people who are no longer requiring acute medical treatment, as soon as possible whilst we face these unprecedented pressures. The impact to these pressures impacts the whole system, and prevent us treating and supporting people who are acutely unwell. Equally for those awaiting discharge, and where they have been a resident with you for some time it is important to people who wish to return to their usual place of residence and to a place of familiarity.
Our Local Authority and CCG colleagues would be happy to support with any questions or risks you have, and whether we can support you to mitigate these risks.