Stories from the COVID-19 pandemic - #OneTeamOneOUH by OUHtrust

Stories from the

COVID-19

PANDEMIC #OneTeamOneOUH

#OneTeamOneOUH

Government guidance on the wearing of Personal Protective Equipment (PPE) and maintaining social distancing measures has changed over the course of the COVID-19 pandemic. The Trust and its staff have complied with this guidance at all times. Any photographs reproduced in this e-Book showing staff not wearing face masks either pre-date the guidance for all staff to wear face masks on our hospital sites or have been taken in non-clinical areas of the Trust where it has been possible to enforce safe distancing for the duration of a photo shoot. FRONT COVER IMAGE: Research Nurse, Emily Taylor, and Senior Sister, Michele Young, photographed at

Horton General Hospital’s Critical Care Unit, May 2020 © Jon Lewis / Oxford Hospitals Charity BACK COVER IMAGE: © Oxford Medical Illustration (OMI), Oxford University Hospitals DESIGN BY:

Oxford Medical Illustration (OMI) – April 2021

THANK YOU Our OneTeamOneOUH response to the COVID-19 pandemic has involved every single part of the organisation. Every member of staff has a unique but equally valid story to tell. We wanted to capture these stories, to give a sense of how it has felt to work during this pandemic. Sharing personal stories, giving voice to staff experience, and understanding each other’s experiences can help us to pause, reflect and celebrate what we have accomplished together, and galvanise us for the challenges to come. Thank you to all staff who shared their experiences to enable us to document this time and to compile a collection of stories which we will be able to look back on in years to come.

contents foreword • Message from Dr Bruno Holthof – Chief Executive Officer, Oxford University Hospitals NHS Foundation Trust

CHAPTER 1: A year like no other

• • • • • •

Our COVID Year – timeline from February 2020 to January 2021 Our year in pictures – OneTeamOneOUH exhibition Working through a Pandemic – a mini documentary Testing times – our amazing Microbiology Team Catching their breath – our Respiratory Team Vaccine rollout – our COVID-19 Vaccination Programme Team

CHAPTER 2: At the heart of global research into COVID-19 • • • • • • •

12 14 16 18 22 26 29

A unique partnership 30 The Oxford Vaccine story 32 ‘V Day’ – our COVID-19 vaccination programme gets underway 36 First in world to deliver life-saving Oxford Vaccine 38 Research stories – Staff Testing Programme / RECOVERY Trial / STOIC Trial / C-MORE Study / CURIAL Study 40 World-class training enhances patient care 46 Medical students step up to the mark 47

CHAPTER 3: Staff voices

• • • • • • • • • • • • • • • • • • • •

50 51 52 53 55 56 57 58 58 59 62 64 65 66 67 68 69 70 72 73

Renal Dialysis Team – Allie Thornley Radioisotope Physics Team – Aida Hallam OUH Rainbow Shielders – Ally Warren Personal reflections from a member of the Finance Team – Martin Harris First impressions last – Stephen Bell Maternity Service Team – Ali Cuthbertson Procurement and Supply Chain Team – Rebecca Ponen Churchill Hospital Elective Swabbing Service – Hayley Smith Hepatology Team – Denise O’Donnell Imaging Physics Team – Helen Amatiello Biomedical Scientist in the Microbiology Team – Emma Thornton Speech and Language Therapist in the Craniofacial Unit – Sarah Kilcoyne Cardiac and Thoracic Critical Care Unit (CTCCU) – Grace Newcomer-Jones SuWOn Division Christmas Jumper Day 2020 – Anna Baker A Christmas Poem from the Paediatric Oncology Team – Amy Mitchell Family Liaison Team at the Horton General Hospital – Esther Marshall Biomedical Scientist in the Cellular Pathology Department – Helena Costa Oxford University Medical Students Staff Testing Team – Zoe De Toledo, Liam Peck and Thomas Ritter Infant Feeding Team – Naomi Morton ‘Game of Prones’: personal reflections on redeployment to ITU – Tom Stevenson

• • • • • • • •

Clinical Governance Team – Helen Cobb John Warin Ward – Helen Marchetti DVT Clinic and Anticoagulation Team – Sam Edwards Personal reflections from our Clinical Lead for Ophthalmology – Stella Hornby Bereavement Services Team – Gaynor Parsons Ward Sister on a COVID ward – Jemimah Lawan Staff Nurse, Respiratory High Dependency Unit (HDU) – Raquel Vicente Staff Nurse, Respiratory High Dependency Unit (HDU) – Marcia Almanzan

74 74 75 76 77 78 80 81

CHAPTER 4: BAME staff stories

• • • • • •

85 86 87 87 89 91

Shift in normality – unforgettable era – Reema D’Souza Combating misinformation in our communities during COVID-19 – Imam Monawar Hussain Adaptive leadership amidst the COVID-19 pandemic – Ariel Lanada Francesca joins OneTeamOneOUH to support BAME staff COVID-19 changed the world for us in 2020 – Lindley Nevers Trust Board commitment to equality, diversity and inclusion

CHAPTER 5: Behind the front line • • • • • • • • • •

Linen Team HR Teams – Resourcing, HR Records and Workforce Informatics Domestic Assistants Digital Team Reception Team Practice Development and Education Teams Pharmacy Homecare Team Voluntary Services Team and our volunteers Clinical Engineering Team Occupational Health Team

93 94 95 98 99 100 101 104 105 106 107

CHAPTER 6: With a little help from our friends

109

• Oxford Hospitals Charity • Charity Support Hubs • Salute the NHS • Project Wingman • Thank you to all keyworkers • Catering and retail partners • Formula 1 nurse and other staff who returned to the front line • Apprentices • Military staff deployed at OUH • University of Oxford medical students • Oxford Brookes University student nurses, midwives and allied healthcare professionals • Thank you to children of OUH staff

110 114 116 117 118 119 120 121 122 123 124 125

(Not) THE LAST WORD

127

foreword by Dr Bruno Holthof – Chief Executive Officer, Oxford University Hospitals NHS Foundation Trust On Tuesday 4 February 2020, we admitted our first COVID-19 positive patients to the John Radcliffe Hospital in Oxford.

And so the idea for this e-Book was born as an opportunity for all staff to share their reflections on our OneTeamOneOUH response to COVID-19.

I think we can all agree that the past 12 months has been a year like no other for everyone working in the NHS – a year of unprecedented challenges for all of us, both professionally and personally.

We invited all teams and staff from across the Trust to submit their contributions for inclusion so that this e-Book could truly reflect the experiences of our people in their own words, in order to create an organic and engaging record of an extraordinary year in the life of OUH.

On behalf of the Trust Board, I want to say a heartfelt thank you for everything that you do each and every day to provide the best possible care for our patients, and to demonstrate compassionate excellence in all that you do. We all have our own individual stories about the highs and lows, the moments of great sadness and those times when hope and our collective spirit have brought us together. One of the ways in which we as human beings can make sense of unprecedented and hugely challenging experiences is by telling those stories, to share how we feel and to talk about what we did as individuals and as part of groups and teams.

I am delighted that we had such a positive response and want to thank all staff who took the time and trouble to share their reflections. I hope you enjoy reading their stories which I am sure will resonate with your experiences over the past 12 months. When I reflect on the past year, OneTeamOneOUH is the cornerstone for all that we have achieved together – our strength has been in our shared sense of purpose which has enabled us to pull together during the darkest times.

DR BRUNO HOLTHOF Chief Executive Officer Oxford University Hospitals © manwithacamera

Garry Tan, Clinical Lead for Diabetes with Geraldine Yebra, Diabetes Specialist Nurse Team Lead © Oxford Medical Illustration (OMI)

For me OneTeamOneOUH is a collective which extends well beyond staff working here at OUH – it includes our brilliant volunteers, the support of Oxford Hospitals Charity, the medical and nursing students from the University of Oxford and Oxford Brookes University who supported our frontline staff, and the groundbreaking COVID-19 research in Oxford. We can be extremely proud of our achievements in the past year: our vaccine development and mass vaccination programme, our test validation and mass staff testing programme, our clinical trials that identified effective treatments for COVID-19, and the many lives we saved by providing excellent and compassionate care. I hope you enjoy reading this e-Book – we would welcome your feedback and your further reflections so please do contact our Communications team with your thoughts via covidquestions@ouh.nhs.uk.

Dr Bruno Holthof Chief Executive Officer, Oxford University Hospitals NHS Foundation Trust Portrait © Panos Pictures

Senior Nurse Practitioner Val Bissett (centre) and colleagues in the Emergency Department at the Horton General Hospital © Jon Lewis / Oxford Hospitals Charity x

Chapter 1 A year like no other

February

2020 FEBRUARY 4 First COVID-19 positive patients admitted to OUH for treatment

FEBRUARY 17 Following national guidance that all hospitals with Emergency Departments (A&E) should install NHS 111 pods, so that anyone attending hospital with symptoms of COVID-19 can be kept isolated from other patients, Portakabins® are put in place at the main entrances of the John Radcliffe and Horton General hospitals

FEBRUARY 18 The Jenner Institute agrees a contract with Italian manufacturer Advent Srl to produce the doses for the first clinical trials of the Oxford Vaccine

March MARCH 11

April APRIL 6

The World Health Organization declares the novel coronavirus (COVID-19) outbreak a global pandemic

Salute the NHS (a national initiative to provide free and nutritious meals to NHS staff) launches at OUH

MARCH 16

The first OUH Charity Support Hub to co-ordinate meals, refreshments and care packs being donated to staff opens at the John Radcliffe Hospital

Visiting OUH hospitals is limited to help tackle the spread of COVID-19

MARCH 23

Visiting restrictions to OUH hospitals are further tightened – no visitors are now allowed with limited exceptions (Maternity, Paediatrics, End of Life Care, etc.) UK lockdown enforced: Prime Minister Boris Johnson announces people may only leave their homes for strictly limited reasons Patients with COVID-19 at the John Radcliffe Hospital are among the first to be recruited to a new clinical trial to test the effects of potential drug treatments for those with the virus – the RECOVERY treatment trial is led by researchers from the University of Oxford

MARCH 24

OUH postpones all routine, planned outpatient appointments and all routine, elective inpatient surgery (in line with national guidance) but maintains urgent and emergency care and cancer treatments – to prioritise the sickest patients and maintain safe patient care

MARCH 26

The first Clap for Carers weekly event takes place

MARCH 27

The Oxford COVID-19 Vaccine Programme starts screening healthy volunteers ahead of a clinical trial

APRIL 13 Government figures show 20,000 deaths from COVID-19 in the UK Second OUH Charity Support Hub opens at Horton General Hospital

APRIL 21 Dr Sachin Mandalia, Clinical Lead for the Emergency Department at the John Radcliffe Hospital, issues a public plea following concerns that people were putting their health at risk by not coming to hospital to avoid overburdening services during the COVID-19 pandemic

APRIL 23

Oxford COVID-19 Vaccine Programme first human clinical trials launched Third OUH Charity Support Hub opens at Churchill Hospital

APRIL 27

Fourth OUH Charity Support Hub opens at Nuffield Orthopaedic Centre (NOC)

APRIL 30 University of Oxford announces an agreement with AstraZeneca for the further development, large-scale manufacture and potential distribution of the vaccine

May MAY 12

New Government advice states that face coverings must be worn in enclosed spaces and on public transport

MAY 18

Keep in Touch, a virtual letter delivery service for patients to be able to hear from their friends and family despite visiting restrictions, is launched at OUH

MAY 20

To mark National Thank a Teacher Day, OUH Chair, Professor Sir Jonathan Montgomery, and Chief Executive Officer, Dr Bruno Holthof write a personal letter to local headteachers to thank them and their staff for everything they are doing during the COVID-19 pandemic for the children of keyworkers in the NHS and other essential services

MAY 22

Researchers begin recruiting up to 10,260 volunteers for the next two phases in clinical trials of the Oxford Vaccine – expanding the age range COVID-19 survivor Ken Wood, who spent nearly three weeks being treated at the John Radcliffe Hospital, tells his story – he says: “I want to take this opportunity to say thank you to the NHS – all those that cared for me – for my life.”

MAY 23

Government figures show 50,000 deaths from COVID-19 in the UK

MAY 28

The last Clap for Carers weekly event takes place

June JUNE 3 A patient at the John Radcliffe Hospital is the first to be recruited to the ATOMIC2 clinical trial to test whether azithromycin can treat the symptoms of COVID-19 in people who feel well enough to be cared for at home

JUNE 13 People who live alone in England can form a ‘support bubble’ with another household, as COVID-19 deaths and cases continue to fall

JUNE 15 In line with Government guidance, patients and members of the public are asked to wear a face covering when visiting OUH hospitals

JUNE 22 New Emergency Department facilities for the John Radcliffe Hospital open – the new space includes nine extra bays for immediate care of the seriously ill, a paediatric resuscitation room, and a dedicated CT scanner for the resus area

JUNE 29

Rule of One visiting is introduced for most inpatient wards as COVID-19 deaths and cases reduce

JUNE 30 First research paper published about the COVID-19 staff testing programme study at OUH reveals different levels of risk faced by healthcare workers dealing with the pandemic – it combines data from both symptomatic and asymptomatic staff testing programmes

July JULY 4

UK lockdown is eased as a range of venues including pubs, restaurants, hairdressers and places of worship reopen on what the media calls ‘Super Saturday’

JULY 8

A major UK research study in which Oxford researchers are playing a key role to investigate the long-term health impacts of COVID-19 on hospitalised patients, is launched – PHOSPCOVID is awarded £8.4 million jointly by UK Research and Innovation and the National Institute for Health Research (NIHR)

JULY 27

Initial research findings on the effectiveness of the CURIAL Artificial Intelligence (AI) test, developed by University of Oxford and used to rapidly screen for COVID-19 in patients arriving at OUH Emergency Departments, are published

JULY 30

The latest research paper published about the COVID-19 staff testing programme study at OUH shows that COVID-19 antibody tests might not give a positive result if people have only had mild symptoms, like loss of taste and smell

August AUGUST 3 Work starts on the new OUH Radiotherapy Centre on the Great Western Hospital site in Swindon which will enable cancer patients to access care closer to home

AUGUST 11 The Trust publishes its Strategy 2020-2025 which will guide our priorities and decisions over the next five years

AUGUST 17 Renal dialysis resumes at the Horton General Hospital in Banbury – the Horton Renal Unit was temporarily moved to the NOC in Oxford earlier in the year as we mobilised our response to the COVID-19 pandemic

September

October

SEPTEMBER 3

OCTOBER 6

SEPTEMBER 7

An international study led by researchers at OUH and published in the Journal of Hepatology shows that patients with cirrhosis are at increased risk of dying as a result of COVID-19

UK records highest daily total of coronavirus cases since early June A study finds that having had a liver transplant does not increase the risk of death from COVID-19 – researchers from the Oxford Liver Unit, based at OUH, and the University of Oxford’s Centre for Statistics in Medicine publish a paper in The Lancet

SEPTEMBER 15

Oxford respiratory researchers find that putting COVID-19 patients in a prone position can lead to improved outcomes – the findings of their study, supported by the NIHR Oxford Biomedical Research Centre (BRC), are published in an article by BMJ Open Respiratory Research

SEPTEMBER 16

Increasing COVID-19 cases in Oxford mean the city is once again on amber alert – this happens when cases rise above 25 per 100,000 of the population

SEPTEMBER 24

The NHS COVID-19 App launches to the public

SEPTEMBER 30

Oxford edges closer to red alert after positive cases double in a week

OCTOBER 12 The Government announces the introduction of ‘local COVID alert levels’, or tiers – medium (tier 1), high (tier 2), and very high (tier 3) tiers were added to with a tier 4 later in the year

OCTOBER 28 More than 6,000 patients who underwent endoscopy at 18 NHS hospitals since the start of the pandemic were tested and none contracted COVID-19 as a result of the procedure, according to a study involving clinicians from OUH

OCTOBER 31 Oxford is moved into the Government’s high (tier 2) COVID alert level after a further rise in cases of COVID-19 – the rest of Oxfordshire is at medium (tier 1) alert level

November NOVEMBER 5

Second national lockdown starts in England and remains in place until December 2 Antibodies to COVID-19 fall by half in less than 90 days, and antibody levels peak lower and fall faster in younger adults, according to the latest research published about the COVID-19 staff testing programme at OUH

NOVEMBER 20

New study, based on data from the COVID-19 staff testing programme at OUH, suggests that individuals who have previously had COVID-19 are unlikely to contract the illness again, for at least six months following their first infection

NOVEMBER 23

Researchers announce full late-stage trial results which show the Oxford Vaccine is 70.4% effective, on average, in preventing COVID-19 after two doses The team from the Oxford Vaccine Group and Jenner Institute who developed a COVID-19 vaccine in record time are shortlisted for the Excellence in Healthcare Award at the NHS Parliamentary Awards after being nominated by Layla Moran, MP for Oxford West and Abingdon

OUR COVID YEAR

2,884 COVID positive patients treated from 4th Feb 2020 to 4th Feb 2021 of whom 2,455 (85.1%) were treated successfully and discharged from hospital. 250 patients required ICU treatment, of whom 179 (71.6%) were treated successfully and discharged.

December

January

DECEMBER 1

2021

MPs vote to replace the second national lockdown with tighter tier restrictions in England

DECEMBER 2 Oxfordshire is placed into the high (tier 2) alert level

DECEMBER 8 Vaccinations start at 50 Hospital Hubs across the country, including at the Churchill Hospital Visiting rules at OUH are tightened – patients on most inpatient wards are still permitted one visitor, for one hour, each day, but visitors must be from the patient’s household or support bubble

DECEMBER 17 Cases of COVID-19 are rising sharply across Oxfordshire – up 50% in just a week

DECEMBER 18 OUH and Oxford Health NHS Foundation Trust are designated by NHS England to run a joint Long COVID service after new research from the Office for National Statistics shows that 20% of people with coronavirus develop longer term symptoms

DECEMBER 23 Visiting restrictions are further tightened – no visitors are now allowed with limited exceptions (Maternity, Paediatrics, End of Life Care, etc.)

DECEMBER 26 Oxfordshire is placed under tier 4 restrictions

DECEMBER 30 The coronavirus vaccine developed by scientists at the University of Oxford with AstraZeneca is approved for use in the UK

JANUARY 4

Retired maintenance worker Brian Pinker (82) becomes the first person in the world to receive the new Oxford-AstraZeneca coronavirus vaccine at the Churchill Hospital

JANUARY 5

Third national lockdown starts

JANUARY 7

The Office for National Statistics reports 100,000 deaths from COVID-19 in the UK

JANUARY 11

C-MORE Study finds that a significant proportion of COVID-19 patients report breathlessness, fatigue and depression several weeks after being discharged from hospital – the study is led by researchers from the University of Oxford’s Radcliffe Department of Medicine and is supported by the NIHR Oxford Biomedical Research Centre (BRC)

JANUARY 15

NHS England data shows 1 in 5 trusts in England are treating at least twice as many COVID-19 inpatients as at the peak of the first wave

JANUARY 22

5.8 million people in the UK have now received their first dose COVID-19 vaccination

Our year in pictures OneTeamOneOUH exhibition ‘Artlink’, the arts and music programme for OUH which is funded by Oxford Hospitals Charity, created an online exhibition of artwork and photography by and for staff during the COVID-19 pandemic. The images included in the exhibition, which are also on display in our hospitals, capture the spirit demonstrated during our response to COVID-19. A selection of the photographs in the exhibition are featured in these pages. The exhibition also includes images of OUH staff created as part of the Portraits of NHS Heroes project. At the beginning of the COVID-19 pandemic, the Oxford portrait painter Thomas Croft decided to offer NHS staff the opportunity to have their portrait painted. He then encouraged other portrait artists to follow suit and display these on Instagram at #PortraitsForNHSHeroes.

Paintings by Xisto Silva, a member of the domestic team working in Intensive Care, were professionally framed by the charity and included in the display. The exhibition also shows photography of staff at work, taken by Horton porter and professional photographer, Jon Lewis, during the spring peak of the pandemic. The OneTeamOneOUH exhibition is available to view on the Oxford Hospitals Charity website at www.hospitalcharity.co.uk/ouhexhibition as well as on each hospital site.

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Many OUH staff took up this offer and we’re pleased to display many of their portraits in our OneTeamOneOUH exhibition. Fatema A A Mulla, Staff Nurse in CTCCU and one of those OUH staff who had her portrait painted, says: “This exhibition is a tribute to those artists who dedicated their time willingly and wholeheartedly to draw and paint some of our staff here. In a moment of difficulty and in challenging times something beautiful was created.”

Alejandro Herrara by Ian Whyte

Carlotta Tomboloni and Francesco Saveno Carolla by Margaret Graham

Carolina Pinto by Mary Jane Ansell

Chiara Bonfatti by Georgia Mallin

Andrea Meloni by Hannah Wheeler

Carlotta Tomboloni and Cristina Arranz Francesco Saveno Carolla by Kristina Vladi by Margaret Graham

Carolina Pinto Denise Wood by Mary Jane Ansell by Charlie Davies

Chiara Bonfatti Eileen Naughton by Georgia Mallin by Katie Patel

Fatema Mulla by Mirjam Dijk

Grace Newcomer-Jones by Jill Powell

Jacinto Martinez by Ian Whyte

Jackie Byrne by Ilona Kiss

Judith Mercader Camps by Lay Lam

Karen Humphreys by Angela Burdon

Cristina Arranz Fatema Mulla by Vladi by Kristina Mirjam Dijk

Denise Wood by Charlie Davies

Eileen Naughton by Katie Patel

Katie Hards by Eugenia Osmani

Kelly-Anne Hamilton by Tarren Malham

Laura Bermejo by Irene Ruby

Maria Ortega Navarro by Ian Whyte

Mohammed Rafique by Tarren Malham

Pavana Pillai by Kelvin Lepley

Sarah Stiddard by Jaime Bullock

Shareen Khan by David Fisher

Stefania Cavaliere by Merlin Bateman-Paris

Stella Hornby by Maddie Abbs-Wood

Toby Visholm by Michael Jules Lang

d that so many OUH is offer and delighted to ection of their portraits here.

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Collective portrait of NHS staff including Chiara Bonfatti by Darren Butcher

Annie Payne by Mike Smith

Izzy Speight by Danny Howes

Portraits for NHS Heroes: Portraits of OUH Staff

#OneTeamOneOUH Izzy Speight by Danny Howes

#OneTeamOneOUH Fatema Mulla by Mirjam Dijk

Rocio Morales Llamas by Becky Paton

Portraits for NHS Heroes: Portraits of OUH Staff

Working through a Pandemic WORKING THROUGH A PANDEMIC is a mini documentary exploring the innovation and adaption that staff working in intensive care at OUH undertook in response to the first wave of the COVID-19 pandemic in spring 2020. The film, which was produced in-house by the Oxford Medical Illustration (OMI) team, gives an insight from within the Trust as to how the unprecedented challenge of the pandemic was met through resourcefulness and teamwork. The production shows what it was like to work through a pandemic and how the Trust and staff reacted to these pressures, as well as highlighting lessons learned for the future. A wide range of staff and a COVID-19 patient speak about their experiences of the virus. In the film, Sam Foster, Chief Nursing Officer at OUH, says: “Our intensive care senior nursing team, in response to the pandemic, worked through very quickly how they were going to cope with this overwhelming demand from patients. “They ran a phenomenal programme refreshing skills for people who had been out of ITU (Intensive Treatment Unit) for some time. They developed a team approach so it felt less stressful.” x

Also featured in the video is OUH patient and COVID-19 survivor Ken Wood, who was cared for at the John Radcliffe Hospital in Oxford for 19 days due to the virus. He received ventilator treatment on the Intensive Care Unit (ICU) for 13 days. In the film Ken says: “I will never forget what has been done for me, and what staff continue to do for others. I send my sincerest thanks and heartfelt gratitude. “You have worked tirelessly for someone who you didn’t know, to save their life. I wasn’t the only one there but you cared for me as if I was. “I believe I have a second chance at life: a second chance to better appreciate my blessings, a second chance to show thankfulness and gratitude, a second chance to address my true priorities and show and reflect love and compassion in my life to others.” The Working through a Pandemic mini documentary is available to watch on the OUH YouTube channel at: www.youtube.com/watch?v=4CbXDgV5l9A

DAVE GARRY: Intensive Care Consultant CAROLYN BARRETT: Relatives’ Liaison, Adult Intensive Care Unit

“We recognised in the early stages that there was a need to address how we deal with relatives and how we deal with patients, in order to bridge that gap. We decided we would phone the relatives every single day and it gave them comfort that they knew they were getting information as to how things were going and progressing.”

“Surviving critical illness is all about marginal gains and so you want to do each little bit really really well.”

“Doing two hours on and two hours off allowed nurses to go in and give their best and make sure that there was a continuous presence of care for that individual patient.”

STAFF WORKING TIRELESSLY ACROSS THE ADULT INTENSIVE CARE UNIT

CHERRY LUMLEY: Senior Sister, Adult Intensive Care Unit

Testing times OUR AMAZING MICROBIOLOGY TEAM The job of our Microbiology Laboratory staff is to test samples from our patients to make a diagnosis of infection. They then provide information on the cause of that infection, and data to guide treatment. The testing of hospital patients for COVID-19 has been a major global focus over the past 12 months, and the pandemic has had a really dramatic impact on Microbiology staff, sometimes overlooked members of the NHS workforce who are now rightly in the spotlight. Their role has been vitally important because testing for COVID-19 has a critical role, both in the management of individual patients, and in outbreak control from a public health perspective. Microbiology carried out a staggering 774,047 tests from February 2020 to January 2021 – including 242,594 COVID PCR (polymerase chain reaction) tests. The team of 90 staff, which increased to 105 staff at the peak of the pandemic, rose to the challenge of providing the additional testing capacity needed. Despite the demand for huge numbers of tests, the quality of testing has never been compromised – ‘every single sample counts’. 18

Dr Bruno Holthof is pictured with Dr Katie Jeffery (Director of Infection Prevention and Control) and Dr Monique Andersson (Consultant in Clinical Infection). Please note this photograph pre-dates guidance for all staff to wear face masks on our hospital sites.

Chief Executive Officer, Dr Bruno Holthof, says: “The work of the team in our Microbiology Laboratory throughout the COVID-19 pandemic has been crucial for not only our local community but also the whole country. We are very lucky to have these exceptional people as part of our Trust. “I would like to thank the Microbiology Laboratory and its extraordinary staff for doing an unbelievable job in very difficult circumstances. They are absolute professionals, and always prepared to go the extra mile – it is a privilege to have you in our team.”

BIOMEDICAL SCIENTISTS Helena Costa and Frances Colles © Jon Lewis / Oxford Hospitals Charity

Following the progress of a COVID swab

Laboratory staff Annie Welbourne, Imogen Clarke, and Jack Dobson.

COVID swabs arrive in the COVID Unpacking Room where they are removed from their outer protective packing and the swabs scanned before their clear plastic tubes are disinfected and have labels applied. Pictured is Biomedical Scientist Robin Terry who was working at Oxford Brookes University and volunteered his services to help the fight against the virus.

The last stage the swab goes through to render it inactive, effectively to kill it using heat. Biomedical Scientist Robin Terry is pictured placing swabs into a heat block.

Chief Biomedical Scientist Marcus Morgan shows the increasing amount of COVID testing taking place by the Microbiology Team during the first wave of the pandemic in 2020.

Research Scientists Steven Fiddamen and Cathy De Lara are shown here loading inactivated samples into the Qiagen Symphony robot. This is one of four Symphony robots brought in to extract DNA from the samples before sending on for PCR.

When the swabs are rendered inactive, they are taken to the Extraction Room. Pictured there using an M2000 extraction and PCR machine (which were increased in number from one to three to meet the test targets) are Biomedical Scientists Helena Costa and Frances Colles.

Catching their breath… OUR RESPIRATORY TEAM The Respiratory Team has been at the heart of the Trust’s response to the COVID-19 pandemic. Originally based on Ward 7E at the John Radcliffe Hospital, the Osler Respiratory Ward moved several times during the course of the pandemic and staff showed great understanding, teamwork and dedication to ensure the continuance of excellent patient care in often challenging circumstances. Happily, the new Osler Respiratory Unit has now moved to a brand new home on Wards 5C and 5D at the JR and staff welcomed their first patients on Tuesday 16 March 2021. The two wards have been completely refurbished in order to provide a single Respiratory Unit with 24 beds, including 22 side rooms and one twobedded bay. Six of the beds are for patients from High Dependency Units and two beds for cystic fibrosis patients. This is great news for patients with respiratory conditions and the staff who care for them alike. Sam Foster, our Chief Nursing Officer, says: “The Respiratory Team has delivered outstanding care to our patients throughout the COVID-19 pandemic.

Henry Bettinson (Clinical Lead) and Helen Disley (Deputy Matron) are pictured in the new Osler Respiratory Unit

They expanded their capacity rapidly and welcomed staff from across our Trust to learn new skills and be part of the response required for our patients. This exciting new area has been completely transformed, and it will make a really positive difference to our patients.”

PICTURED RIGHT: Physiotherapist Patricia Costello collects a standing hoist to mobilise a patient © Oxford Medical Illustration (OMI)

PICTURED CLOCKWISE FROM LEFT: ■ Recovering

COVID-19 patient Nigel Morgan is relieved to find out that he will soon be going home ■ One final consultation with his doctor before being discharged after seven weeks in hospital ■ Nigel is reunited with his family. He thanked staff for the care he received and said he was delighted at the way he had been looked after: “I am humbled actually and that’s the truth, the nurses are marvellous.” © Oxford Medical Illustration (OMI)

Vaccine rollout OUR COVID-19 VACCINATION PROGRAMME TEAM The Trust’s COVID-19 vaccination team administered almost 30,000 vaccines in just three months after the first Pfizer vaccine was delivered on 8 December 2020 – bringing new hope to health and care staff from not only OUH but also our partner organisations, as well as people aged over 80. Our vaccination programme was initially based at our Hospital Hub in OCDEM at the Churchill Hospital – one of just 50 locations nationally where the first COVID-19 vaccines were given – and over time two more hubs were set up at both the John Radcliffe and Horton General. OUH’s role was to provide COVID-19 vaccinations for health and social care and local authority staff, as well as the over 80s (cohort 4) and in their first three months the team vaccinated: more than 20,000 NHS staff across the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICS) – including OUH staff l 3,000 social care staff l 2,000 care home workers l 2,500 patients l

The OUH vaccination team brought together a wide range of staff from across the Trust who made this all possible. David Walliker, our Chief Digital and Partnerships Officer, who has led the Trust’s vaccination programme, says: “It has been a huge logistical challenge across the NHS to set up the processes to vaccinate so many people so quickly. “I would like to thank all of our staff who have responded so magnificently. The work done by our pharmacy, estates and digital staff to get the vaccination hub set up has been matched only by the work of our super team of vaccinators and all those who have been helping support the vaccination programme.” Please see page 32 for the inside story of the development of the Oxford-AstraZeneca COVID-19 vaccine, ‘V Day’ (8 December 2020) when the first Pfizer vaccines were administered in our Hospital Hub at the Churchill Hospital, and the day when history was made as the world’s first Oxford-AstraZeneca vaccine was administered at OUH (4 January 2021).

PICTURED CLOCKWISE FROM TOP LEFT: ■

The first Pfizer vaccine is prepared (Boo) Vadher, Chief Pharmacist and Clinical Director, Pharmacy and Sterile Services ■ Patient James Fowler receives his COVID-19 vaccination on ‘V Day’ at the Churchill ■ Sam Foster, Chief Nursing Officer, with Dr Nick Woodthorpe, a Consultant Psychiatrist at Berkshire Healthcare NHS Foundation Trust who received his COVID-19 vaccination at the Churchill Hospital on 8 December 2020, ‘V Day’ ■ Bhulesh

A researcher at the Jenner Institute carries out tests on the Oxford -AstraZeneca coronavirus vaccine © John Cairns, University of Oxford

Chapter 2

At the heart of global research into COVID-19

Oxford is one of the most vibrant places for healthcare research in the world because of the close working relationship between clinicians at OUH and the world-class University of Oxford academics and researchers who work alongside them. The strength of this unique partnership has become even more apparent during the COVID-19 pandemic when Oxford has been at the very heart of global research.

A unique partnership OUH and the University of Oxford working together The development of the Oxford-AstraZeneca vaccine to protect people from COVID-19 is the best known example of this world-leading research – culminating in the first Oxford Vaccine being administered right here at OUH on 4 January 2021. But there are numerous other examples, a selection of which are highlighted in this e-Book, together with other ways in which the University and OUH have worked together throughout the pandemic to benefit patients and staff.

Oxford Vaccine Group team

MORE INFORMATION about COVID-19 research led by the University of Oxford is available on their website at:

research.ox.ac.uk/coronavirus-research

The Oxford Vaccine story A truly remarkable achievement The University of Oxford’s Jenner Institute and Oxford Vaccine Group have been at the forefront of developing vaccines against diseases of major global importance for more than 30 years. Together with partners around the world, they developed Oxford’s coronavirus vaccine which has brought new hope to millions of people across the world in the fight against COVID-19 – the first vaccine was delivered at the Churchill Hospital in Oxford on 4 January 2021. Dr Bruno Holthof, our Chief Executive Officer, says: “I am proud of the strong partnership between OUH and the University of Oxford, especially in the area of the vaccine clinical trials. Hundreds of healthcare workers at OUH took part in the vaccine trial; they can be rightly proud of the role they have played in keeping their patients, colleagues and wider community safe.” Vaccines usually take decades to develop and so this is a truly remarkable achievement which has its origins in the lessons learned from the Ebola outbreak in 2014-2016, and in particular years of planning how to develop a vaccine in the shortest possible time for the next unknown infection.

Central to this plan developed by Professor Sarah Gilbert and her colleagues at the Jenner Institute was the construction of ChAdOx1 – or Chimpanzee Adenovirus Oxford One – through which scientists took a common cold virus that infected chimpanzees and engineered it to become the building block of a vaccine against coronaviruses. When worrying reports first began to emerge from Wuhan, China, in early January 2020 – and then Chinese scientists shared the full genetic code of the coronavirus – the Oxford team swung into action. They had already developed a ChAdOx1 vaccine for Mers – from the same family of viruses – and so they weren’t starting from scratch. But even so the pace of safely developing the Oxford Vaccine, demonstrating its efficacy, gaining regulatory approval and making it available for use not only in the UK but globally, was extraordinary – as our timeline from January 2020 to February 2021 demonstrates (see page 34).

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ABOVE: Professor Sarah Gilbert RIGHT: a range of tests carried out at the Jenner Institute as part of the development of the vaccine – (top to bottom) blood processing, an ELISpot assay and flow cytometry

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OXFORD VACCINE TIMELINE 2020 JANUARY 20 The Oxford team starts work on a developing vaccine to prevent COVID-19

SEPTEMBER 2 A new arm of the late-stage clinical trials is launched in the US

FEBRUARY 18 The Jenner Institute agrees a contract with Italian manufacturer Advent Srl to produce the doses for the first clinical trials of the Oxford Vaccine

OCTOBER 26 AstraZeneca announces that the vaccine produces an immune response in both young and old adults

MARCH 27 The Oxford COVID-19 vaccine programme opens for clinical trial recruitment APRIL 23 Phase I clinical trials start in the UK across multiple study sites including Oxford APRIL 30 The University of Oxford announces an agreement with AstraZeneca for the further development, large-scale manufacture and potential distribution of the vaccine MAY 22 Researchers begin recruiting up to 10,260 volunteers for Phase II / III clinical trials in the UK – expanding the age range JUNE 23 Clinical trials start in South Africa JUNE 28 Clinical trials start in Brazil JULY 20 Results of the Phase I / II trial, published in The Lancet, indicate no early safety concerns and show the vaccine induces a strong immune response

NOVEMBER 23 Researchers announce full late-stage trial results which show the Oxford Vaccine is 70.4% effective, on average, in preventing COVID-19 after two doses – these findings show that the Oxford team has developed an effective vaccine that will save many lives DECEMBER 30 The UK Government accepts the recommendation from the Medicines and Healthcare products Regulatory Agency (MHRA) to authorise the emergency use of the Oxford-AstraZeneca vaccine in the UK

2021 JANUARY 4 Brian Pinker, 82, becomes the first person in the world to receive the Oxford-AstraZeneca vaccine – at the Churchill Hospital in Oxford FEBRUARY 13 A UK Phase II study is launched to assess the safety and immune response of the vaccine in children and young people aged 6-17 years old at multiple study sites including Oxford Find out more about the Oxford Vaccine story at:

www.ox.ac.uk/oxford-vaccine

PICTURED CLOCKWISE FROM TOP LEFT: ■

Professor Andrew Pollard Processing serum at the Oxford Vaccine Group ■ Receiving samples at the Jenner Institute ■

‘V Day’ Our COVID-19 vaccination programme gets underway Tuesday 8 December 2020 – ‘V Day’ as the media called it – was a momentous day for the NHS in Oxfordshire as we started the COVID-19 vaccination programme at OUH with the PfizerBioNTech vaccine. We were part of the biggest and most highly anticipated immunisation campaign in history with the Churchill Hospital designated as one of 50 Hospital Hubs to deliver the vaccine. Less than a week after the vaccine was approved by the Medicines and Healthcare products Regulatory Agency (MHRA), thanks to the incredible work of OUH staff, we started vaccinating people over 80 years old, care workers and frontline NHS workers from Oxfordshire, West Berkshire and Buckinghamshire in line with Joint Committee on Vaccination and Immunisation (JCVI) prioritisation. Dr Bruno Holthof, our Chief Executive Officer, said: “This is a hugely significant moment in our pandemic response, and offers hope at the end of what has been an incredibly difficult year. I would like to thank all of our staff who have done such a tremendous job to get our Hospital Hub set up at such pace.

“This has been a great achievement of team working by our estates, digital, pharmacy and clinical staff, with the support of many more.” David Walliker, our Chief Digital and Partnerships Officer and lead Executive Director for our COVID-19 vaccination programme, added: “For the past few weeks we have been working closely with colleagues across Oxfordshire, Buckinghamshire and West Berkshire to plan how we will offer vaccinations to the local population and our staff as soon as we are able to.” Sam Foster, our Chief Nursing Officer, said: “I have been proud to play my part in delivering the first vaccinations on this historic day in our battle against the pandemic.” ‘V Day’ at OUH attracted national and international media interest – you can read the full story in The New Yorker at www.newyorker.com/news/ letter-from-the-uk/the-immense-relief-ofhealth-care-workers-receiving-the-vaccine

PICTURED CLOCKWISE FROM TOP LEFT: ■ COVID-safe

waiting area, complete with perspex screens ■ David Walliker, Chief Digital and Partnerships Officer, pictured at the Vaccination Centre ■ The Pfizer BioNTech vaccine is prepared and ready to be administered ■ Public Health England information leaflets

First in world to deliver life-saving Oxford Vaccine 4 January 2021 was an historic day for the NHS and for OUH as we launched the rollout of the new Oxford-AstraZeneca coronavirus vaccine – OUH dialysis patient Brian Pinker was the very first person in the world to receive the Oxford Vaccine from Sam Foster, our Chief Nursing Officer. Brian, aged 82, a retired maintenance manager who has been having dialysis for kidney disease at the Churchill Hospital for a number of years, said: “I am so pleased to be getting the COVID vaccine today and really proud that it is one that was invented in Oxford.” Sam Foster added: “It was a real privilege to be able to deliver the first Oxford Vaccine at the Churchill Hospital here in Oxford, just a few hundred metres from where it was developed.” Dr Bruno Holthof, our Chief Executive Officer, said: “We are very proud that the Churchill Hospital in Oxford was chosen to be the first location to provide the Oxford Vaccine. I would like to pay tribute to the team here in Oxford who developed this vaccine in record time.”

Professor Andrew Pollard, a paediatrician working at OUH who is Director of the Oxford Vaccine Group and Chief Investigator of the Oxford Vaccine Trial, was also vaccinated. He said: “It was an incredibly proud moment for me to have received the actual vaccine that the University of Oxford and AstraZeneca teams have worked so hard to make available to the UK and the world. “As a paediatrician specialising in infections, I know how important it is that healthcare workers along with other priority groups are protected as soon as possible – a crucial role in defeating this terrible disease.”

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The world’s media came to Oxford on 4 January 2021 Vadher (Chief Pharmacist) with Sam Foster (Chief Nursing Officer) and Professor Meghana Pandit (Chief Medical Officer) ■ Brian Pinker is vaccinated by Sam Foster ■ Professor Andrew Pollard gives a ‘thumbs up’ after being vaccinated by Sam Foster ■ The Oxford-AstraZeneca vaccine ■ Bhulesh

Research stories STAFF TESTING PROGRAMME OUH has led the way in developing COVID-19 staff testing programmes which have not only kept staff safe – and enabled them to protect patients – but also played a key role in developing the understanding of different levels of risk faced by healthcare workers during the pandemic. This in turn has enabled the Trust to develop and adapt its approach to keep staff as safe as possible. The initial research study, published in June 2020, was the first to comprehensively investigate all staff groups across an institution, and combined data from both symptomatic and asymptomatic staff testing programmes. The study is a major collaboration between OUH and the University of Oxford, with support from the NIHR Oxford Biomedical Research Centre (BRC) and Public Health England (PHE). The initial research findings in June 2020 demonstrated how the testing programme was able to: l

identify and isolate staff who had the infection before they developed symptoms, preventing them passing infection on to other staff and patients identify in which areas of the hospital staff were at greatest risk

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identify which staff groups were at greatest risk record which staff had antibodies to the virus that causes COVID-19, enabling these staff to be monitored to understand if these antibodies provide immunity against repeat infections.

Based on the findings, the Trust implemented an infection prevention and control plan to limit transmission of COVID-19. Two further research studies, published in November 2020, showed that: l

antibodies to COVID-19 fell by half in less than 90 days, and that antibody levels peaked lower and fell faster in younger adults and those who showed no symptoms people who have previously had COVID-19 are highly unlikely to contract it again, for at least six months following their first infection.

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Flow Device

Dr Bruno Holthof, Chief Executive Officer at OUH, says: “Since the outbreak of COVID-19, the Trust and the University have worked closely together to develop highly reliable PCR and antibody testing to support the research and care in the fight against the virus. Our comprehensive staff testing programme is revealing a regular stream of valuable information as we try to better understand how to tackle this disease. “I’d like to thank all those involved in delivering the programme and the more than 12,000 people who work at our hospitals who have participated.” Susan Hopkins, Deputy Director, National Infection Service, PHE, says: “Studies like this one are absolutely vital in helping us to understand how this new virus behaves and what the implications are for acquired immunity. I am deeply grateful to my colleagues at the University of Oxford and to all the participants who continue to volunteer to assist us in this critical work.”

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Microbiology Laboratory

Infection prevention and control clinicians and researchers at OUH outlined how we deployed self-administered home-based lateral flow testing for staff in a letter published in the Journal of Infection in February 2021. These tests were in addition to the Trust’s existing asymptomatic staff PCR testing programme. Of 46,503 lateral flow tests performed by asymptomatic staff, 328 (0.7%) were positive, their positive predictive value (the probability that subjects with a positive screening test truly have the disease) was 96%, while the false positive rate was just 0.03%. Dr Katie Jeffery, OUH Director of Infection Prevention and Control, says: “This lateral flow testing system has been an important way for us to help reduce the spread of COVID-19 in our hospitals. We’d like to thank all the thousands of staff who have participated and reported their results.” 41

RECOVERY TRIAL discovers new treatments for COVID patients Oxford University researchers are leading the Randomised Evaluation of COVID-19 Therapy (RECOVERY) Trial, the world’s biggest trial looking at whether existing treatments can tackle the symptoms of COVID-19 – by March 2021, almost 40,000 people were taking part in the trial globally. The Chief Investigators are Professor Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, and Professor Martin Landray, Professor of Medicine and Epidemiology in the Nuffield Department of Population Health.

“This world-leading study shows the power of well-designed clinical trials to discover which drugs can help patients.” Dr Tim Clayden, Bursar of the University of Oxford’s Green Templeton College, took part in the RECOVERY Trial after being admitted to the John Radcliffe Hospital with COVID-19. He says: “I’m really happy to help with research because the more data they get, the more healthcare staff are able to start helping. Even though I was feeling so ill, at least I was doing something positive.”

They have made a number of breakthroughs. In June 2020 they announced that one of the drugs they were testing, dexamethasone – a cheap and widely available steroid – reduced the risk of death in COVID-19 patients on ventilators by a third, and by a fifth in those on oxygen. l

Find out more about the RECOVERY Trial at:

www.recoverytrial.net

In February 2021 they announced that another of the drugs they were testing, tocilizumab – an anti-inflammatory treatment – reduced the risk of death when given to hospitalised patients with severe COVID-19 and also reduced the need for a mechanical ventilator. l

Professor Fiona Watt, Executive Chair of the Medical Research Council, says: “It’s incredibly encouraging that doctors now have additional COVID-19 treatments that can save lives and reduce the length of hospital stays. 42

After being successfully treated for COVID-19, Tim Clayden returns home

STOIC TRIAL reveals common asthma treatment can reduce hospitalisation Early treatment with a medication commonly used to treat asthma appears to significantly reduce the need for urgent care and hospitalisation in people with COVID-19, researchers at the University of Oxford have found. The STOIC Trial, supported by the NIHR Oxford Biomedical Research Centre (BRC) and AstraZeneca, also found that giving the inhaled steroid budesonide to patients with COVID-19 within seven days of the onset of symptoms reduced recovery time – findings were published in February 2021. Professor Mona Bafadhel, of the University’s Nuffield Department of Medicine, who led the trial, says: “There have been important breakthroughs in hospitalised COVID-19 patients, but equally important is treating early disease to prevent clinical deterioration and the need for urgent care and hospitalisation. “I am heartened that a relatively safe, widely available and well studied medicine such as an inhaled steroid could have an impact on the pressures we are experiencing during the pandemic.” A participant in the STOIC Trial

C-MORE STUDY confirms longer term impact of COVID-19 A study looking at the longer term impact of COVID-19 has found that a significant proportion of COVID-19 patients discharged from hospital reported symptoms of breathlessness, fatigue and depression several weeks later. The C-MORE Study, led by Dr Betty Raman and Professor Stefan Neubauer, both from the University of Oxford’s Radcliffe Department of Medicine, has used Oxford’s state-of-the-art imaging facilities to assess the long-term effects of COVID-19 infection on not only the lungs but also the heart, liver, kidney and brain. The findings were published in January 2021 in the first peer-reviewed paper to be published on the impact of COVID-19 on multiple organs using imaging. In October 2020, the team published their initial findings, which detected abnormalities on MRI in multiple organs, indicating that persistent or chronic inflammation may be an underlying factor for these changes among COVID-19 survivors. C-MORE has been supported by the NIHR Oxford Biomedical Research Centre (BRC) and the NIHR Oxford Health BRC, as well as the British Heart Foundation’s Oxford Centre for Research Excellence and the Wellcome Trust.

The University of Oxford’s Oxford Centre for Clinical Magnetic Resonance Research (OCMR) at the JR. Please note, this is a library image which pre-dates COVID-19 pandemic guidance for all staff to wear face masks on our hospital sites.

CURIAL STUDY uses AI to screen Emergency Department patients for COVID-19 Oxford scientists specialising in infectious diseases and clinical machine learning developed an artificial intelligence (AI) test to rapidly screen for COVID-19 in patients arriving at our Emergency Departments at the John Radcliffe Hospital in Oxford and the Horton General Hospital in Banbury. The test assesses data routinely collected during the first hour in Emergency Departments, such as blood tests and vital signs, to determine in near real time the chance of a patient testing positive for COVID-19.

David Clifton, Professor of Clinical Machine Learning in the University of Oxford’s Department of Engineering Science, says: “This project is a great example of what can be done, and at very great pace, to fast-track the development of technologies to help in the current pandemic – and to increase the resilience of the country’s healthcare system for any future events.”

Results of the CURIAL Study, published in December 2020, showed that the AI test correctly predicted the COVID-19 status of 92.3% of patients coming to our Emergency Departments during a two-week test period. The CURIAL AI test offers clinical teams the potential to rapidly and confidently rule out a diagnosis of COVID-19 for a large majority of the patients who do not have the infection, while identifying patients at higher risk of testing positive. The higher-risk patients can then be cared for in clinical areas with additional infection control precautions while swab test results are awaited.

World-class training enhances patient care Oxford Simulation, Teaching and Research (OxSTaR) is the University of Oxford’s state-ofthe-art medical simulation teaching and research facility based at the John Radcliffe Hospital in Oxford.

Dr Helen Higham says: “I am so proud of how the team in OxSTaR and all the faculty who work with us (largely from the OUH) have trained and supported staff in safe practices during the pandemic.”

The OxSTaR team, led by Dr Helen Higham and part of the Nuffield Division of Anaesthetics in the University’s Nuffield Department of Clinical Neurosciences, runs simulated scenarios to observe, develop and test how healthcare professionals work together and interact with their environment and equipment.

MORE INFORMATION about OxSTaR is available at www.oxstar.ox.ac.uk

COVID-19 presented many new challenges for our clinical staff and OxSTaR’s role was key. Educational materials, developed in collaboration with the OUH Infection Prevention and Control team, about how to safely don and doff personal protective equipment (PPE) l Training in techniques to assist patients’ breathing l ‘Human factors’ training to support clinical teams to work together to maintain patient safety l A library of training materials made available online for healthcare professionals globally l

In-situ intubation training

Medical students step up to the mark Students from the University of Oxford Medical School took on a wide range of supportive roles across the Trust during the COVID-19 pandemic. Professor Meghana Pandit, our Chief Medical Officer, says: “On behalf of the entire Trust Board at OUH, I would like to thank all the medical students who stepped in to help us care for our patients during the COVID-19 pandemic. “They took on numerous roles, such as helping with donning and doffing PPE, distributing meals, enabling conversations between patients and families digitally, staff testing, and much more. They did this without hesitation and always with a smile.

“The thing that will really stay with me is how during the busiest days we would sometimes sit and hold the hands of patients, so there was someone by their side. With those that were well enough I had some really lovely conversations, with some it was all about reassuring them if they were a little distressed and for others it helped provide comfort to their families. “I feel so privileged to have done this – it is a time I will never forget and I know it will be with me throughout my future career in medicine.”

“Compassion and effective communication are key qualities of a good doctor and our medical students have demonstrated these during their interactions with both patients and staff. We are very proud of them all and wish them all the very best for their future careers.” Alex Tough, a medical student who started helping out in March 2020, says: University of Oxford Medical students Alex Tough and Madeleine Oliver

Speech and Language Therapist Holly Davies donning level 2 PPE © Oxford Medical Illustration (OMI)

Chapter 3 Staff voices

We invited teams and staff from across the Trust to submit their contributions for inclusion in this e-Book about our OneTeamOneOUH response to the COVID-19 pandemic. This was because we wanted it to truly reflect the experiences of our people in their own words, to record and reflect on an extraordinary year in the life of OUH. Our staff didn’t disappoint – thank you to everyone who took the time to get involved.

Renal Dialysis Team by ALLIE THORNLEY Matron and Clinical Lead – Renal Medicine Driving to work on 9 March 2020 I heard on the radio that Boris was to hold a COBRA meeting to consider the impact of COVID-19 on the UK. I had the realisation this was going to impact us. I looked at the effect of COVID on dialysis patients in Italy and was shocked. That same day the Oxford Kidney Unit (OKU) had its own COBRA meeting (who would have ever though it meant Cabinet Office Board Room!). The Sister’s office sufficed for our COBRA. There were three people in attendance: matron, deputy matron and lead technician. Our initial action was to create a dedicated isolation dialysis unit which would provide a facility for any infected dialysis patient – from any of our seven units. It involved emptying a daycase unit that happened to be plumbed for dialysis and moving phlebotomy to a staff room. We were so lucky to have this space. We have a team that works together and is flexible. This whole plan transcended process / policy / infection control with speed that was unprecedented. The move happened on 15 March. We moved quickly to twice weekly unit manager and consultants’ meetings and everyone contributed to the plans – some unsure about whether this was real, some feeling it was overkill. So came Saturday 21 March … Within a week we had our first two COVID positive dialysis patients. Both were outpatients and the newly created isolation unit was ready.

To be confident in the process, the deputy matron and myself rostered ourselves to do the dialysis. We needed to be confident in the conversion of the clinical area, and more importantly the ‘doffing’ of PPE. Over the next few weeks the pace continued as we converted all outpatient appointments to telephone clinics and we expanded our ability to dialyse patients in several locations which included the isolation unit and medical wards at the JR. And then … On Easter Monday I learned of a supply problem for hemofiltration fluid in one of the local district general hospitals. We set up dialysis and supported them. Within seven days we were providing dialysis in seven intensive care units. By the end of June we had done more than 250 sessions in patients with critical illness who may have otherwise died. I am proud to be part of a team who responded with such speed, enthusiasm and a ‘can do attitude’ which meant we all pulled together to keep not only our patients well cared for but also those in critical care teams. Many staff were redeployed – we provided a ‘line insertion’ team to the JR, the PD manager ran her programme almost single handed, anaemia nurses supported critical care in Bucks, academic teams backfilled clinics so consultants could be released to medicine, and the renal technicians plumbed and replumbed so many bed spaces in critical care areas. I cannot say how proud I am to be part of this team. Thank you to everyone in the Oxford Kidney Unit!

Radioisotope Physics Team by AIDA HALLAM Consultant Clinical Scientist Head of Radioisotope Physics The Radioisotope Physics team provides support to users of radioactivity across all OUH sites and has continued in this vital role throughout the COVID pandemic. We have worked flexibly and imaginatively to help departments and develop ways of working that meet their needs, while reducing the risk of transmitting the virus, keeping both our staff and patients safe. We made rapid developments with regards to staff training, enabling medical and clinical staff to complete mandatory radiation training online via e-LMS. This supported clinical teams through difficult times by allowing essential training to be delivered at more convenient times and with less risk compared with in-person sessions. We provide all essential support services through a combination of on-site and remote assistance during the pandemic. This includes continued image quality and safety tests of equipment, including PET/CT and gamma cameras at various sites, surgical gamma probes used in theatres, calibration of radioactivity measuring/detecting equipment, dealing with radioactive waste etc. These ensure that the calibrated equipment provides optimal image quality to aid in patient diagnosis or treatment and ensure staff safety. We upgraded our image processing servers and set up optimised software to further develop the imaging services we support. This allowed improved image processing and more efficient processes and facilitates remote support for clinical departments.

Our support to the radioisotope therapy service, which uses radioactivity to treat various cancers, has enabled the service to continue during the pandemic. We worked closely with radiology and the oncology nursing and medical teams to identify ways that patients could be treated safely to minimise the risks of patients catching COVID while they were radioactive. The aim was to reduce these risks through testing and shielding around the time of the treatment. In addition, we helped identify ways to minimise the radiation risks to staff associated with close care in the event that a patient did become infected. Due to the efforts of our team, working with others in the Trust in a multidisciplinary approach, these vital cancer treatments have been able to continue uninterrupted through the second and third lockdowns and we have also directly assisted other teams providing the treatments during staff absences. Our continuous review of procedures and risk assessments in all radiation departments ensures that the Trust continues to comply with all radiation-related regulation and follow best practices for the medical use of radioactivity as the pandemic progresses. Despite being a small team of scientists and technical staff we have adopted new ways of flexible working, using staff rotas which has helped improve service resilience by minimising the chance that the whole team will need to self-isolate, to ensure continuity in these vital services. Working collaboratively though these unusual times has been a resounding success. All team members have been engaged in developing new ideas to effectively and constructively work together. We continue to support our colleagues and patients and hope to sustain the many improved work processes to provide a lasting and positive improvement in the services we provide.

OUH Rainbow Shielders by ALLY WARREN Team Leader Anaesthetics Nuffield Orthopaedic Centre Theatres The OUH Rainbow Shielders group came into being following a conversation that I had during a Clinical Supervision session. I had been shielding since March 2020 due to having had a kidney transplant in July 2019. Understandably, having spent much of 2019 suffering from renal failure and then recovering from the transplant surgery, I had hoped 2020 would be a better year. Shielding came as a surprise, as it did to many people, and I was feeling quite lonely, missing my work colleagues, and also feeling helpless as I really wanted to do something useful. During a chat at one of my Clinical Supervision sessions I talked about how I’d been feeling. One of the suggestions to help with my anxieties was to organise a Microsoft Teams meeting to meet with other shielding staff in the Trust. Although I thought this was a good idea, I had had very few Teams meetings and had never organised one so I was a little unsure about the prospect of doing this. With some encouragement from family, friends and colleagues I set a date and put together an advert for our first meeting. It was great to have a project to focus on and I also felt that I finally had a purpose. I didn’t know if anyone would want to come to the meeting but slowly members of staff started to email to ask for the meeting link.

A friend kindly offered to have a practice Teams meeting with me which made me feel a lot more confident about hosting the upcoming shielding meeting. We had our first meeting in June 2020, it was fantastic to be able to talk to other members of staff who were doing what I was doing, shielding! We chatted about our experiences of shielding, how we came to be shielding and our hopes and fears for the coming months. It was reassuring to hear that I wasn’t the only one who had worries about my career, my pay, getting sick, or one of the endless concerns that COVID brought. We made each other laugh, we had virtual hugs, and we knew we weren’t alone. We continued to meet over the summer and then until Christmas. We now continue to meet fortnightly to support each other, chat, ask questions or just listen during this next period of shielding and beyond. Lots of staff who have joined the group at one time or another have now returned to work – some in their own roles, some in different roles, some shielding again. Staff pop in and say hello at our meetings when they can and it’s great to hear how everyone is coping with the ever changing situation that COVID brings to their lives. From one small comment has grown a caring and friendly group, who in this unprecedented time can offer support to our fellow clinically vulnerable staff. For me personally the group has meant I no longer feel alone. I have made new friends, and it helped me to have a purpose in this pandemic.

Personal reflections from a member of the Finance Team by MARTIN HARRIS Assistant Finance Business Partner – Corporate I’ve been working in the NHS for almost 29 years. I know I’m lucky. I’m not part of the amazing frontline staff who have been dealing with COVID-19 patients. I’m not a Board member or senior member of staff having to make sometimes quick and difficult decisions to ensure that the Trust gets through these times. I’ve been working from home to keep myself and my mum out of hospital (I’ve been a type 1 diabetic for almost 44 years). I’ve realised the challenges facing the NHS since last March. My next door neighbours but one both died from coronavirus in March 2020 (one at the JR, one at home), as well as one of my dad’s cousins. Work colleagues have had the virus and I know of one who even lost her mother with it. We’ve had the wonderful district nurses regularly visit my mum, although they sensibly reduced their visits with me quite happily changing my mum’s leg ulcer dressing once a week. The things that have helped me at work have been technology, everybody’s positive attitude and working as a team. It seemed almost within no time our finance systems team, along with IM&T, got us all functioning with phones diverted to our mobiles, laptops all working despite my internet provider being more of a challenge.

Now I don’t know how we ever managed before having virtual meetings using Microsoft Teams and simple messages on Chat. We’ve even dealt with a change in our finance system partway through the year. When change comes along you can either resist or embrace it and realise that it can be stimulating to learn new things, even if sometimes there’s extra pressure. To keep the whole Finance team at the Trust together, a weekly newsletter was started, edited by Lisa Sealey, with people making contributions – some of it technical and some of it to simply help everybody’s wellbeing. I’ve enjoyed making contributions to this newsletter with the aim of helping staff think, understand and keep going in these hard times. In early January 2021 I wrote about the ‘Triumph of Science’. I mentioned the great work that goes on here in the Oxford area. Our Chief Nursing Officer, Sam Foster, had just been on the national news talking about the Oxford-AstraZeneca vaccine having just given the first vaccine to an Oxford patient. Whichever area we work in at the Trust, we all worry about the pressure on the NHS due to COVID-19. However, I realised that the vaccines give us hope so we can see light at the end of the tunnel. Watching Sam on television, I felt very proud to be part (even if a very small part) of our Trust.

First impressions last by STEPHEN BELL Operational Services Manager – Maternity There is nothing more daunting than a first day in a new job and a new organisation. You want to give the best impression, you want to show that the company made the right decision to employ you, but most of all you want to feel like you’ve made the right decision. I moved from the independent sector back into the NHS as an Operational Service Manager in Maternity, a service that I knew little about other than being on the father side of a family journey. You can imagine my anxiety rise as I am taking a much needed family break in between jobs in Ibiza, only for Boris to announce on our second day that those arriving back from Spain must quarantine for two weeks. Mind racing, I emailed my new employers. Within a couple of hours I had the assurance that I needed. ‘Everything will be OK’.

‘Enjoy the rest of your holiday’. ‘We understand’. ‘We will arrange for a laptop and mobile phone to be delivered and we will set up two weeks of remote introductions and inductions’. Mind calmed. This simple and effective message was clear. My new team really cared and valued me. This began our relationship based around a solid foundation of trust, commitment and communication. I wholeheartedly believe that first impressions are essential. I gave mine as best as I could through a screen and remote working. The Maternity service had already gone above and beyond before I’d even started, and as a result I will always give that little bit more.

Dr Bavidra Kulendrarajah pictured in the Emergency Department at the John Radcliffe Hospital © Jon Lewis / Oxford Hospitals Charity

Maternity Service Team by ALI CUTHBERTSON Director of Midwifery During the COVID pandemic there has been one constant in the Maternity Service; babies will be born and families will be created. The service has seen the same number of births as expected and the services have continued. We are proud to say that throughout the pandemic, despite the significant challenges, we have continued to offer high risk tertiary care as usual and have adapted and used innovation to provide remote care; for example the ability for women to self-monitor their blood pressure as part of the care planned. Women have been able to continue with their choice of birthplace; whether this is at the JR, the Spires, our midwifery-led units or at home. We have created Community Hubs, we have amalgamated clinics, and provided face to face postnatal care. The teams have led by example in delivering compassionate care, they have implemented national changes and pathways to keep women and families safe. The changes have been coproduced with the Oxford Maternity Voices Team, and there have been huge successes in reaching out to those we look after via social media; for example we have run lots of Facebook Live sessions on numerous topics. There have been new services created for bereaved families to support them at the time of their initial loss and then follow-up specialist care from the Rainbow Clinic.

Our Lotus Team has provided an outstanding continuity of service for those most vulnerable families and the community. Specialist services have also successfully launched continuity of carer pathways in partnership with the whole Maternity Service. While 2020 was hugely challenging, we managed to reach full staffing and support staff with training online and a preceptorship package. Our students, both medical and midwifery, have been vital; they have worked with us to deliver the safest care. Staff have been redeployed to cover staff shortages with kindness and understanding. We have worked hard on our IT needs and been successful with external funding bids. Throughout all of this challenging time we have been one team with one vision; to be the very best we can be, to deliver the best care.

Procurement and Supply Chain Team by REBECCA PONEN Procurement Office and Performance Manager Global healthcare supply chains were disrupted immeasurably by the COVID pandemic and challenges with the national response exacerbated the issues in the UK. Ensuring that our staff had consistent supplies of PPE required an immense effort by all hospital procurement and supply chain teams in very difficult market conditions. The majority of staff from our team were immediately deployed to form a COVID Supplies Response Team. Large numbers of PPE and other critical items needed to be sourced and managed locally from a range of new suppliers in a very short timeframe. A dedicated central store was established with satellite stores in the COVID clinical areas. The team worked tirelessly seven days a week through Bank Holidays and long into the night to ensure that staff had appropriate PPE at all times. Close collaboration with the clinical teams ensured all stock was quality checked before issue to ensure staff safety at all times. In total we have issued well over 22 million pieces of PPE since 1 April 2020, at peak issuing nearly 500,000 pieces per day. We sourced local products to support demand, building a sustainable local supply route which will continue into business as usual. Non-frontline Procurement and Supply Chain staff worked from home to deliver data analysis and catalogue support and the purchasing team worked tirelessly to process enormous numbers of requisitions and purchase orders. The excellent recovery rate achieved for COVID patients at OUH was primarily due the skill and care of our clinical teams, but the Procurement and Supply Chain team like to think we played a small part by ensuring they had all the PPE and equipment they needed to provide such excellent care.

Our work in identifying new sources and supplies of PPE focused on developing relationships with new local suppliers and, where possible, on using reusable and sustainable products. Our work with local suppliers secured significant supplies of reusable face masks that are such a critical component of personal protection. This supplier and other local suppliers worked with us above and beyond the call of duty to ensure the people of Oxfordshire and our local communities were protected. The team quickly built partnerships with other organisations from global organisations like DHL, who also have local operations in the Oxford area, to individual volunteers in the local community. The team supported our colleagues in the community, in charities and care homes, often taking stock in their own cars out of hours to deliver urgent supplies. These collaborative working relationships will endure long past the COVID pandemic. The response to the crisis has brought the team together and new ways of working will serve the organisation well going forward. We are working to ensure that our new local suppliers form a key part of our future supply chain resilience, support our sustainability objectives, and also help the Trust fulfil our responsibilities as an anchor institution for the region. We are already in discussions with some of our COVID response partners to understand how we can work together to identify and develop best practice in the healthcare supply chains with a view to sharing that across the wider NHS – a ‘Healthcare Supply Chain Academy’ for the future.

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Churchill Hospital Elective Swabbing Service by HAYLEY SMITH Matron – Oncology and Haematology The COVID-19 guideline for arranging planned care in hospitals and diagnostic services, published by NICE in July 2020, advises that all patients should be tested for coronavirus no more than three days before admission to hospital, and that results should be available beforehand. To fulfil this requirement, the Churchill Hospital set up an on-site drive through swabbing service. The Churchill Hospital Elective Swabbing Service (CESS) is delivering approximately 70% of Trust swab testing. CESS was set up in March 2020 and was combined with the existing phlebotomy service. Although initially set up to support the SuWOn clinical Division, due to practicalities and its success the service was expanded Trustwide. Scheduling takes place in EPR and patients attend a drive through appointment. The service grew quickly and now undertakes around 3,000 swabs a month, with a maximum number of 3,879 swabs carried out in November 2020. I run and manage CESS on behalf of the SuWOn Division and we have continued to be successful in recruiting staff to support a service which is now well-established.

Hepatology Team by DENISE O’DONNELL on behalf of the Hepatology Nursing and Admin Teams From a quick conversation back in March 2020 with Dr Katie Jeffery, the Director of Infection Prevention and Control, and Fiona Warren, the Occupational Health Manager, discussing our Hepatology Nursing Team winding down our community service due to COVID-19 restrictions, to then assisting in the set-up and running of symptomatic and asymptomatic staff testing in the Trust, COVID-19 has had a huge impact on our team. When I asked our team to describe their experience this is what they had to say – ‘Outstanding teamwork, adaptability and flexibility’; ‘Rising to and excelling in new and challenging areas and facing the unknown’; ‘Reassured by working in a caring and supportive team during uncertain and rapidly changing times’. At times and over many months we worked seven days a week, we swabbed outside when it was too hot, too cold and too wet but every day we had time to laugh, sometimes cry and support each other, which was hugely important. We had days in asymptomatic staff testing when we tested 350+ staff. We were very well fed through those super busy months by many generous groups. We still talk about the chocolate brownies! We started early and finished late but we did it and through it we met and got the opportunity to work with some fantastic people. From swabbing to phlebotomy and admin, the Hepatology Team has made a very memorable contribution, and continues to do so, to our Trust staff testing programme.

Imaging Physics Team by HELEN AMATIELLO Clinical Scientist / Radiation Protection Adviser Head of Imaging and Non-Ionising Physics Towards the end of February 2020 we became aware that we may need to change our approach to work and pretty quickly. At management level, we began to consider how we might have to adopt homeworking imminently. Our group is one of the many teams within OUH of Healthcare Scientists and Technologists. We support the work of X-ray users throughout the Trust, ensuring radiation equipment is operating safely and advising the Trust on compliance with the various radiation protection regulations. A pre-planned meeting became a brainstorming session, considering how we might quickly adapt working practices. We decided to split into distinct teams to safeguard service delivery and prioritised equipment to best support. We had to plan for homeworking where possible, and ensure resources were still available for use. We still had trainees to support and their training to deliver. Almost the next day, 17 March, we had to adopt everything we had planned for with immediate effect. The next few weeks were spent reacting to all the information that was being cascaded in real time. As we are traditionally a non-clinical team working in clinical environments, we slipped through the gaps for some of the cascaded instruction and had to adopt approaches rapidly as we saw fit, adapting it to our work.

The needs of Radiology were paramount in our minds as they tried to operate X-ray equipment in new locations, all whilst adopting altered patient and staff safety procedures. We ensured that the Trust via existing governance structures was made aware of the changes to guidance and regulation being issued from Government organisations and regulators as it became available, notably the Health and Safety Executive (HSE) and Care Quality Commission (CQC). We liaised nationally with professional colleagues via our professional body, sharing learning from other trusts and problem solving together. In summer 2020, we took stock and conducted a local staff survey to investigate what had gone well and not so well over the preceding months. We hope the tweaks made as a result of that improved our service and internal support structure. The team also had to become used to remote working, trying to incorporate MS Teams into daily life – a steep learning curve. We instigated weekly catch-up meetings and separate online ‘coffee breaks’ to try to keep everyone together. We found that communication, humour and support for each other were key. Sharing jokes on WhatsApp (comparing mask styles, Star Wars memes, as is normally found in the realms of Physics) and meeting virtually maintained a sense of cohesiveness and inclusivity. All at a time where everyone wanted to deliver the best possible service to the Trust, whilst dealing with the worry and strain of the pandemic both in work and at home. In some ways the last year has made our team stronger and taught us new skills and ways of doing things, which we can take forwards in our work and our ongoing support of other OUH teams.

STAYING UPBEAT Staff at the Horton General Hospital © Jon Lewis / Oxford Hospitals Charity

Biomedical Scientist in the Microbiology Team by EMMA THORNTON Senior Biomedical Scientist At the start of 2020 I was beginning the exciting countdown to 3 April, the day I would marry my fiancé. I was also incredibly excited about seeing my Dad and brother who I hadn’t seen for two years, since they both live in Thailand. As January progressed the coronavirus outbreak in China was growing worse, and by the end of February our laboratory was receiving swabs from returning travellers with suspected COVID. In the beginning, since we didn’t have the capabilities for testing, we were packaging them up and sending them to the reference laboratory. As the days went by and the volume of swabs grew, this became a more and more time-consuming task. On the night shift we would arrange a courier and a driver who would turn up every night around 4am ready to drive the samples down to Southampton to ensure they made it on to the morning run. At the start of March work was underway to establish an in-house coronavirus assay. A large A3 piece of paper was put up in the lab with all the overtime that would be required for the next few weeks. I remember being amazed at how fast the shifts were filled and thought, “what an awesome team we have!”.

Around the second week of March, our in-house coronavirus assay was up and running. I remember the day we managed to test and report 100 swabs and what an achievement it was – little did we know that at the peak of the first wave we would reach 1,500 in one day! By the end of March the whole laboratory team had to be split into two teams. Our daytime hours were changed from 7am-3pm and 3pm-11pm and the teams would alternate shifts each week. This would help to maintain social distancing and ensure there were enough people on each shift to maintain the service. While it was sad to be split up, everyone took this in their stride and got on with it. As the number of swabs we were testing steadily increased, the COVID shifts became full on and stressful. The alternating shifts each week also began to take their toll and I remember there were a few Friday late shifts where I would be overcome with emotion from the exhaustion of it all. Come the summer everyone was starting to take some well-deserved time off; despite this many people were still feeling weary from the previous months. It’s now January 2021 as I write this, and we have just had one of our busiest days ever. Our COVID testing is constantly evolving and we now offer a much faster turnaround time which has had a massive impact on staff morale within the department, whilst greatly benefiting the rest of the Trust. Alas, I am still not married and I’m patiently awaiting the day I will be reunited with my Dad and brother!

Speech and Language Therapist in the Craniofacial Unit by SARAH KILCOYNE Principal Specialist Speech and Language Therapist – Oxford Craniofacial Unit and Spires Cleft Centre Communication is at the heart of my job role. The PPE requirements during the COVID pandemic have presented unusual obstacles to communication with our patients with hearing impairment and speech and language disorders. So much of what is central to my job was obscured by PPE in the early days of the pandemic. Our team needed to rapidly problem-solve to work out how we could do our jobs safely, but also accurately and effectively. In keeping with the #OneTeamOneOUH response, we received support from multiple specialist areas of the hospital to help us achieve this goal. We worked with the OUH Procurement team who took the time to understand our specific needs, and gave us kit (including visors and goggles) to try out. We received specialist visor toppers to make children’s experiences as fun as possible. We also had visits from specialist Infection Prevention and Control nurses who assessed our work spaces, and helped us come up with some unique ways to maintain distance. Our custommade Perspex screens were an absolute gamechanger, permitting us to still conduct assessments safely, but also engage children.

The clear face masks have proven very important to ensure effective communication with children. We received support from the Play Specialists to make bespoke stickers so children could see we were still smiling underneath our face masks! In summary, the pragmatic, safe and excellent approach from supportive colleagues in OUH has enabled us to continue to provide excellent communication support to our children and families with Cleft Palate, Craniofacial conditions and Facial Palsy. Thank you OUH.

Cardiac and Thoracic Critical Care Unit (CTCCU) by GRACE NEWCOMER-JONES Deputy Sister – Cardiac and Thoracic Critical Care Unit (CTCCU), Oxford Heart Centre My first experience of COVID seems so long ago it is a distant memory. However, even though there were times of strain and stress, there were also times of joy and hope. It is an important and memorable life event. My attitude was to take each day as it comes. I hardly listened to or read the news. Instead, I got up and out for work as normal, ready for another shift. One thing I love about my job is that each shift is different, you never really know what will happen. This was especially true in COVID times where because half our unit was COVID and the other half ‘clean’ for long-term and emergency cardiac and thoracic patients, I found out when I got to the unit where I was allocated. I remember when our unit was preparing for COVID in February and March 2020. We were collecting equipment to double up our bedspaces – double the amount of ventilators, beds, monitors, safety equipment and oxygen. Week by week waiting for patients to arrive, COVID being an uncertain and unknown event. Fast forward to January 2021 when Adult ICU and we were completely full of COVID patients.

Team One go into the COVID unit as soon as they arrive, don in full PPE and take handover from the night staff to look after between two and four patients depending on patient dependency, sometimes three ventilated patients at one time. For nursing staff, we have a particularly important routine where we only stay in for two hours. Team Two will come in at 10am and take over to allow Team One to have a break, ready to go back in at midday and so on for the rest of our shift. Break time – yay! An opportunity to catch up with documentation, prepare medications or any equipment that inside might need, and most of all eat, drink and rest from the busyness of inside. We were fortunate to have constant supplies of food, toiletries and gifts donated from the hospital charity and various communities and companies all coming together to support us. At the end of the shift, we had a brief wellbeing huddle which was a relaxing and safe space to offload together. Not only having rests at work but also resting at home was essential. I was truly grateful to have my boyfriend (now husband) looking after me at home. I work with an amazingly resilient and adaptable team. There are certain memories of patients and people who positively shaped my experience of COVID inside and outside of work who I will never forget. I am fortunate to have kept healthy and safe throughout this time. I am proud to call myself a COVID ICU nurse at the John Radcliffe.

A day shift would be as follows; start at 7.30am, look on the staff room door for our allocation.

SuWOn Division Christmas Jumper Day 2020 by ANNA BAKER Executive Assistant, SuWOn Division The SuWOn Division took part in sharing their festive spirit by wearing their weird and wonderful Christmas jumpers on Christmas Jumper Day on Friday 11 December 2020. Not only did we have some fun but also we were very proud to raise £194 for charity Save the Children. The winners of our Christmas Jumper Day Competition 2020 were announced in the days leading up to Christmas. 1st Prize went to our colleagues in the Renal Day Case Team at the Churchill Hospital – Aklima Khatun, Mumthas Abdul Jalal, Dee, Gill Goddard, Amanda, Charmaine and Smiley. A special mention to Vicky Bint, Jacky, Libby, Susette and Nicola who weren’t able to attend but supported from a distance. What a fantastic and significant picture that captured the team’s festive positivity after a year of COVID-19 in 2020. The SuWOn Divisional team was very pleased to see the festive jumpers, smiles and poses, along with safe distancing and awareness of what 2020 has entailed. To all our clinical staff, who couldn’t wear your Christmas jumpers in the workplace, thank you for taking part at home and for sending in your entries. 2nd Prize went to Hayley Smith, our Matron for Oncology and Haematology, who sent in this fantastic photo – yes, this really is Hayley, dressed in her full-length Christmas tree jumper!

A Christmas Poem

from the Paediatric Oncology Team by AMY MITCHELL Consultant, Paediatric Oncology

This year has been so extraordinary, a year like no other, Affecting each person, each child, friend or brother. As Christmas approaches, your loved ones held near, We want you to know we wish you much cheer. Thank you for your service, your work and your drive. For keeping our amazing department alive. As we constantly strive to all do our best, please don’t forget you also must rest. We look to the future with excitement and awe, embracing the new year and all that’s in store. Merry Christmas and a very happy New Year. THE KAMRAN’S CONSULTANT TEAM 67

Family Liaison Team at the Horton General Hospital by ESTHER MARSHALL Deputy Unit Manager – Rowan Ambulatory Unit As the COVID situation developed, medical wards at the Horton faced many challenges, not least of which was ensuring families were kept updated on their loved one’s condition. It was a strange new world where visitors were not permitted within the hospital. The Rowan Ambulatory Unit closed and a small team of nurses from the unit were redeployed to form the Family Liaison Team. Our aim was to provide regular daily phone calls to the next of kin and provide a point of contact, so ward staff could deliver care with fewer interruptions. With a member of the ward staff joining our team, emotions ranged from the anxiety of redeployment, to relief at having a role, to the realisation of the phone calls we would be faced with. And the strangeness of sitting behind a desk all day was not to be underestimated. Setting up a service from scratch is always a challenge and a frantic two days was spent brainstorming what we could realistically hope to achieve, and how we could communicate this to the ward staff and families. We were grateful for input from the Acute Oncology Service, Palliative Care Team, Bereavement Office and many other individuals, as we tried to define our limitations and responsibilities.

As we often spoke to the same relative each day, we became aware of the wide range of needs arising during the lockdown period and attempted to signpost people to the relevant services where appropriate. We prepared for potentially difficult scenarios of imparting bad news. But no two calls were ever alike, and we listened to a range of emotions from loneliness, isolation and helplessness, to genuine concern for colleagues working on the wards. Sadly, many families did face bereavement during this time and we offered support where appropriate. To be able to be on the end of the phone, listening to tears and emotions, anecdotes and questions, was, we hope, of some comfort. As the service progressed we were able to make handwritten messages from families to patients, laminating the cards to prevent cross infection. These heartfelt messages were often very personal and it was a privilege to be able to deliver them. It has been lovely to receive appreciative comments and cards from families, and hear the positive feedback from ward staff. What did we learn? It was a steep learning curve and at times emotionally challenging. We realised how much we value face to face communication in our day to day roles. We learned that for all our varied experiences and resilience, it’s still okay to be human, to be upset and to share it with colleagues. And that chocolate and caffeine can often help!

Biomedical Scientist in the Cellular Pathology Department

I didn’t even realise it was affecting me all that much until I started feeling my heart pounding fast in my chest every time I heard anything about the coronavirus numbers on the news.

by HELENA COSTA Senior Biomedical Scientist

Work was a very welcome ‘distraction’ from what was going on in the world – especially when that work was a very important job for the good of my community. And the job did its job for me – it helped keep me sane and focused. I was welcomed with open arms by an impressive team in the Microbiology Department who worked tirelessly under an enormous amount of pressure to deliver more and faster testing every day. They rose to the challenge – and I’m so glad I had the chance to help.

My name is Helena Costa and I am a Senior Biomedical Scientist working in the Cellular Pathology Department at the JR. In order to respond quickly to the urgent need for SARS-CoV2 tests (PCR tests) in the beginning of the pandemic, the Microbiology Department reached out to other departments in the Trust as well as the University in order to recruit volunteers with experience in PCR. I was one of the volunteers and from the end of March until the end of November 2020 I split my working hours between Microbiology (helping with the SARS-CoV2 testing) and Cellular Pathology. Working in two different departments was challenging but also an exciting experience that allowed me to learn essentially a whole new job in a short period of time with new protocols, procedures, colleagues, and responsibilities while also adjusting to a different working shift pattern and doing my best to fit into a new team. Throughout these months, it was hard to deal with the uncertainty and the constant terrible news coming from all over the world regarding the growing number of cases and deaths caused by the coronavirus. Like everyone else, I felt worried about the possibility of it affecting my family, my friends and my colleagues.

Meanwhile, in the Cellular Pathology Department the workload started to go up again from July/ August 2020 and what I saw was an incredible response from the amazing team that I am fortunate to belong to – I stood by their side ‘in battle’ as much as I could as well. I look back at these challenging months and I believe I have learned a lot, not only a new job but also about myself (my physical and mental health, my priorities and how much my thoughts affect my wellbeing) and those around me. I felt a huge support from the managers as well as my team mates in both departments and that made it possible for me to come this far – thank you all from the bottom of my heart. Let’s beat this thing and enjoy our lives safely – we’re almost there!

Oxford University Medical Students – staff testing team by ZOE DE TOLEDO, LIAM PECK and THOMAS RITTER On behalf of the Oxford University Medical Students staff testing team In March 2020, Oxford University medical students received word that studies would be put on hold whilst OUH began to battle COVID-19. At first we were stuck at home, frustrated at not being able to support the NHS when it needed help the most, however soon requests for volunteers started to arrive. Students were deployed to help with a variety of activities, from triaging Emergency Department patients to acting as donning and doffing buddies in the Intensive Care Unit. In late April, 19 students ventured ‘up the hill’ to the John Radcliffe Hospital for what was described by Dr Lumley as a ‘COVID Phlebotomy Project’. Little did we know that this would evolve into what is now the extensive COVID-19 staff testing programme at OUH. Those first days were a novel experience for everyone, requiring all our powers of innovation and creativity. The service has expanded and continues to adapt as the landscape around us changes. In July, our medical studies resumed, however we were given the opportunity to keep working alongside our studies. We now have a team of over 200, coming from a wide array of disciplines, and it has been rewarding and fulfilling in many ways. Selfishly, it has provided relief from total lockdown, but more so it has been a welcome opportunity to support our hospitals and staff in a way that is rarely possible for us as students.

It is easy to feel siloed from the main hospital, with a lack of a permanent role to play in the rotation-based course structure. However, this crisis has afforded us an opportunity to provide a tangible service. Not only have we had the chance to hone our clinical skills at an unprecedented rate (though one does still occasionally miss the vein…) but also being responsible for the administrative side of outpatient clinics offers future doctors a humbling insight into the requirements needed for the smooth provision of services. It has been a pleasure to assist and we hope to have provided comfort to all those staff tested so far. We have learned from the very best, in particular the indefatigable Hepatology and Occupational Health teams. Some of the most rewarding experiences have come from learning new skills from our nursing colleagues, and then having the chance to pass on these skills to new waves of students. Despite the huge interruptions to our education, we are sure that this experience with the COVID staff testing team will make us better doctors. Those first days may have been wildly different to the efficient well-oiled machine that runs now but the aim has always been the same – to test and support asymptomatic staff.

Students from the University of Oxford Medical School took on a wide range of supportive roles across the Trust during the COVID-19 pandemic

Infant Feeding Team by NAOMI MORTON Infant Feeding Team Midwife COVID resulted in a dramatic change to our working week. In March 2020 our four weekly county wide Specialist Breastfeeding Clinics were suspended. This removed really essential and valuable specialist feeding support to many mothers and their babies from newborn up to six weeks of age. We provided telephone and Attend Anywhere online support, which helped many but didn’t replace face to face support and only gave us a limited reach. Whilst we spent a lot of time on the postnatal wards, mothers were going home quite rapidly after birth and many mothers need additional support in the weeks after birth, not just the first few days. The Oxfordshire Maternity Voices Partnership started offering Maternity teams an opportunity to communicate live to the women of Oxfordshire on Facebook Live via their Facebook page.

On 21 April we nervously faced a screen and facilitated a question and answer session with teaching and feeding tips interspersed with the questions. It was brilliant and we had a huge response. We enjoyed doing this so much that we suggested continuing to do this session weekly. We have now facilitated 36 live sessions with between 750-1,200 views each week. We have provided valuable feeding information, support and encouragement to many, and picked up families needing additional support. This has meant that families have been supported in their homes, whether here in Oxfordshire or further afield. We know we have had views in China (a former colleague) and Australia (a former service user). Our colleagues in Maternity report that the women they encounter, both antenatally and postnatally, say how helpful these sessions have been in preparing them for feeding, overcoming problems or pre-empting them. As a team we now often find that we do not have to introduce ourselves when we meet a woman on the wards as we will be greeted with “I have seen you on Facebook Live”. We will continue with these sessions for as long as they are needed.

‘Game of Prones’ Personal reflections on redeployment to ITU at the John Radcliffe Hospital during the COVID-19 pandemic by TOM STEVENSON Orthopaedic Registrar – Proning Team When the lockdown came in March 2020, I was working as a Royal Navy Orthopaedic Registrar within OUH. A general feeling of tension and anxiety descended upon the nation as we entered into the unknown. Busy hospital corridors were eerily deserted. The roads looked like the apocalypse had struck. The chilling words from our Italian medical colleagues posted worldwide on social media echoed in my mind. They warned us very simply: ‘Get ready’. As cases began to ramp up, myself and my orthopaedic peers were ultimately redeployed to provide proning teams to ITU as the peak of illness was anticipated. We entered proning training with some excitement and trepidation, a strong ‘band of brothers’ bond forming between us from the off. Grouped together as orthopaedic surgeons along with physiotherapists, occupational therapists and neurosurgeons, we came under the auspice of a Paediatric Orthopaedic Consultant, who took command to bring our manpower services to the ITU department. Her leadership was exemplary and further inspired us to offer our help in whatever way possible. A strangely familiar mentality quickly came over me. It felt comparable in many ways to my deployed military experiences on the front line in Afghanistan back in 2011. Entering the donning room for the first time and getting into my PPE and preparing to walk into the COVID-19 front line filled me with the same fear I felt before setting out on my first foot patrol, with my rifle in hand.

Led by an incredible and welcoming group of ITU physios, we leapt headfirst into the work. The department was busy. They had lost staff to isolation and illness. The conditions in PPE were uncomfortable and limited the number of staff available at any one time to try and safely mitigate their time spent in PPE. It quickly became apparent how demanding the manoeuvre of proning was on manpower numbers and why our assistance was requested. I truly felt that I was doing my part in fighting this terrible disease: We proned, we helped roll patients for nursing care, we emptied bins. We even started drawing artistic images alongside our names on our plastic aprons in the donning area (including my favourite, ‘The Prona Lisa’), to boost morale. We just wanted to help facilitate the regular ITU staff. I was overwhelmed with the incredible care given by so many battle-fatigued nurses and other health professionals within that department. It felt very positive to have been a part of that. As the proning teams were eventually stood down once that first peak had passed, I felt sorry to leave the ITU teams to continue the fight without us, though knowing of course that they would manage. That same feeling of anxiety washed over me as, in January 2021, we reformed the proning teams and I prepared to re-enter ITU, knowing the numbers were much worse than last time…

Clinical Governance Team

John Warin Ward

by HELEN COBB Head of Clinical Governance

by HELEN MARCHETTI Staff Nurse – John Warin Ward

We are a relatively small team covering a wide portfolio and would be described as ‘not frontline’. We rapidly deployed on 17 March 2020 to work from home and turned all of our governance meetings and training sessions into Microsoft Teams meetings; we had no idea at that point that we would still be working from home into the New Year.

I am a Staff Nurse and have worked in the Trust for 25 years on John Warin Ward. Our specialty is Infectious Diseases and Tropical Medicine.

To support the COVID-19 effort we have done the following.

• Supported the rapid learning from Learning Disability COVID-19 deaths • Added COVID-19 categories to our incident reporting

system and developed COVID-19 reports for regular reporting to our Serious Incident Group (SIG), in conjunction with Health and Safety and Infection Prevention and Control teams Managed the distribution of multiple COVID-19 Central Alerting System (CAS) alerts and created a log of these for the operational COVID-19 meetings Managed the increased frequency of Technologies Appraisal Group (TAG) meetings to facilitate new technology in relation to the pandemic requirements Redeployed staff to provide assistance to Pharmacy, ICU and in the distribution of charitable donations

• • •

We have also kept ‘business as usual’ going as far as possible throughout and supported our Clinical Governance colleagues across the OUH as part of #OneTeamOneOUH. We are proud to be working at OUH and also of the Trust’s partnership with Oxford University and the work towards the development of a vaccine and treatments for COVID-19.

I am proud to be part of an amazing team of doctors and nurses who have been at the forefront of treating this new and astonishing virus since the beginning of last year. Our ward team has evolved, adapted and developed new skills in record time. We have embraced new machinery and technology in what has been a battle to treat an ever growing healthcare crisis. The pace of change in the early days was extreme as we learned more about the virus. Updates were disseminated at an extraordinary pace. Pinning posters on information boards was almost a full-time job! Team members have fought their own illness, only to return and continue on the front line. Despite fear, fatigue, sadness and loss, behind our masks we still find time to smile and give our patients hope and instil confidence. I’m pretty sure that we will be treating COVID on John Warin Ward for many years to come and it has already become part of our norm.

DVT Clinic and Anticoagulation Team by SAM EDWARDS Specialist Nurse We are the DVT and Anticoagulation Team. We run nurse-led DVT diagnostic clinics and provide remote care and management for anticoagulated patients across Oxfordshire. Throughout this last year many of our own team members have tested positive for COVID-19 or COVID antibodies, some with few symptoms, but others became very unwell and experienced ongoing symptoms. As a team we have pulled together to ensure the clinics are manned and our patients are safe, despite at times crippling staff shortages. The teamwork during this difficult time has been quite extraordinary and heart-warming. We have adapted to updated protocols and Standard Operating Procedures on a constantly evolving basis. We have had team members who have had bereavements overseas and not been able to travel home to be with family due to travel restrictions caused by the pandemic. The genuine care and support that we as a team have for each other has helped many of us through difficult times. We have seen so many changes over this year. At the start of the pandemic many patients were being switched from Warfarin to Direct Oral Anticoagulants (DOACs) to reduce the number of INR blood tests required, and we were able to help provide counselling in order to ensure that this was done safely.

We have seen how COVID-19 has become a new provoking factor for VTE and have helped manage patients newly anticoagulated in the aftermath of infection and hospitalisation with COVID-19. We have had patients terrified to leave their houses due to the risk of the pandemic but needing blood testing and in response have stepped up our home visit programme. Due to reduced clinic capacity, patients’ fears about entering the department, and ongoing COVID-19 infection we have seen patients in their cars in car parks outside our centre. We have minimised the numbers of patients coming into the outpatient clinics where safely possible. We have lost patients to this virus and we have listened to patients tell us of their losses of friends and family. As an outpatient clinic which manages many patients remotely, our phone call is sometimes the only contact a self-isolating patient has had for a while and they are often pleased to have the opportunity for a chat. Our personal and social lives have been restricted – no Christmas parties or nights out or even a get together for coffee. In the grand scheme of things this is a small and some may say insignificant thing, however not being able to get together or give or receive a hug when needed has been incredibly frustrating. Restrictions eased, then locked down again due to the second wave and new more contagious strain of COVID. We now cling to the glimmer of hope offered to us by the vaccine that has been recently rolled out, and are facing the new challenges presented by helping our cohort of often high-risk and elderly anticoagulated patients to take up the vaccine.

Personal reflections from our Clinical Lead for Ophthalmology by STELLA HORNBY, Consultant Ophthalmologist and Clinical Lead for Ophthalmology – Oxford Eye Hospital In a week we went from almost normal to ‘war footing’ with work and home life totally changed. Not what I was expecting less than five months into being clinical lead! The Eye Hospital closed to non-urgent cases, breath shields on slit lamps, Pret take out only. As I cycled through Oxford I realised I was cycling through an emotional rollercoaster of grief reactions for my old world and old life and then worried that I might fall off my bike and need A&E or worse an operation! Like stress testing the banks, this rollercoaster was a stress test of character. The entire Eye Hospital rose to the challenge with great teamwork and ingenuity in my team and humans in general! I Learned a new word ‘cyberchondria’ where opening Twitter causes you to feel ill! Total global and financial meltdown on top of work and health anxiety. Next GCSEs cancelled, schools shut, pubs and restaurants closed, lockdown, panic buying (didn’t have time but had stockpiled a bit for a no deal Brexit last year so had tea bags). It was sad that our fellows mostly left to go back home. Some silver linings – no traffic or parking problems, no appraisals or revalidation, nobody caring about job plans, 52 week or 18 weeks etc., lots of things which seemed important didn’t matter for a few months. Why do we have GCSEs anyway? Grateful for having an electronic patient record, telephone triage, email advice service and virtual clinics set up which we could rapidly scale up.

The Ophthalmology department in Wuhan, where the coronavirus epidemic started, lost two ophthalmologists including their head of department and the whistleblower Li Wenliang. I am most proud to say that we did not lose a member of staff of my department to COVID (so far), thanks to PPE. None of us knew what to do in March 2020 and we have proved that a bunch of intelligent resourceful humans can achieve a lot when we have to. Thankful for the memes and funny videos which have been an important part of my personal coping strategy. Proud my hospital immediately started trialling treatments for COVID-19 and scientists in Oxford produced a vaccine in less than a year. I am very proud of my team who have all worked incredibly hard to meet the challenges thrown up by COVID including consultant colleagues working on the front line in Eye Casualty when the trainees were redeployed. They are all heroes and deserve medals. I have done CPD on ‘Pandemic Fatigue’ (Burnout from chronic stress 2020 style). I have got this, as well as everyone I know. The initial excitement of the pandemic has long since worn off and we are missing the holidays and treats which normally sustain us. I am holding out hope for the spring, my second dose of vaccine, and to when I can hug my Dad and book my next holiday abroad.

Bereavement Services Team by GAYNOR PARSONS Bereavement Services Manager I have always been incredibly proud of the Bereavement Services Team but this year I feel they have exceeded all expectations. Their willingness to support and share their knowledge and processes with other organisations showed their commitment to ensuring that all families were given the right information and support at one of the most difficult times in anyone’s life. We could see the impact that COVID-19 was likely to have on us as a service and the families we support, and a contingency plan for continuing to provide the best support possible for families was quickly put into place. One of our first changes was to stop seeing families face to face to reduce the footfall on all of our hospital sites, and to keep our team safe we started to work a rotation of one week in the office followed by one week working from home. We worked closely with a number of external services including the Coroner’s Office, Registration Services, local nursing homes, and Funeral Directors across the country to put a cohesive and inclusive plan into place. These plans involved agreements with the following:

• Registration Services for the Medical Certificate

Certifying Death(MCCD) to be scanned and emailed across to their main offices

• Mortuary Services for handing over cremation

• Oxfordshire County Council’s Death Management

Process Group, meeting twice weekly to share guidance, and keep up-to-date with the latest county and national COVID figures and any new guidelines coming out from the Government

• Other healthcare professionals and organisations

outside the Trust who had no experience of dealing with arranging funerals or processing paperwork for the deceased

It was also important for us to support the doctors who were coming to the offices to complete the paperwork, looking physically drained, so tea, coffee, biscuits, sweets or cake were always on hand. Staff in the office ensured property was received, properly recorded and packed; doctors were supported and paperwork was completed correctly; a rigid cleaning schedule was maintained; the new Medical Examiners who came into effect right in the middle of the pandemic were supported. Staff working at home handled all phone calls; spoke to every family; worked with the Funeral Directors to make sure that they were aware that there were cremation forms, patient property and valuables to be taken when they collected the deceased for the families from the Mortuary. I am so proud of this team and the dedication and hard work they have shown to ensure all families feel fully supported, not once complaining about long days or weekend working.

Well done to the Bereavement Team.

forms, patient property and valuables to the family’s Funeral Director of choice which helped reduce movement on site

77 xx

Ward Sister on a COVID ward by JEMIMAH LAWAN Sister – Interim SSW 5b Well … I start 2020, new year, new me, new opportunities and experiences … who knew that the cheers at midnight 2019 would evolve so differently! Looking back, last year really was a different year! The things that came greatly affirmed the mantra. The beginning was not at all envisioned, and little did I know this would affect me, or you, but everyone. Things became more serious than I thought, seeing around me colleagues, friends, loved ones affected by the virus. The first wave of COVID brought about the responsibility of managing a designated COVID ward. The emotional strain, the sad endings, and happy moments of recovery, but with the support from the Matron, and a courageous fantastic team on my side, we were more than determined to see year 2020 through.

Entering the Intensive Care Unit at the John Radcliffe Hospital © Jon Lewis / Oxford Hospitals Charity

Hidden behind a mask and the unknown circumstances, the staff focused on what was important: teamwork, wellbeing and supporting each other to deliver the best care they could to the unexpected patients they received. Spring was cancelled, summer and the winter but, despite not being able to spend this time how we wished, I was part of a team who encouraged and bonded over what was an unprecedented time of the year. OUH and Oxford Hospitals Charity played a big part in providing support from delivering food parcels, wellbeing, access to advice and mental health support. The Trust certainly went above and beyond to look after the staff who were caring for the patients during this challenging time.

Perspectives from two Staff Nurses working on the Respiratory High Dependency Unit (HDU) RAQUEL VICENTE Staff Nurse, Respiratory HDU I worked in ICU from the middle of February until September, before then moving to Respiratory HDU where I have been working since September. I can say without a doubt that 2020 was the most challenging year personally and professionally in my nursing career since I graduated in 2017. I have seen more people dying last year than in any year before that. They were difficult times, the fear when someone’s vital signs kept on dropping and knowing that we were doing everything that we could and yet they were still fading away. Personally, I had moved to another city and to a new house by myself, so I had to deal with all of that as well. They were grim times from March until August when I finally managed to live with someone else. But, despite being a very dark year, there were some good things worth mentioning as well. I saw the most brilliant teamwork that I have ever seen. I worked with fantastic people and, while we had our sad moments of mourning and complaining how bad things were, there was laughter as well when someone tried to make everyone’s day better.

And we also saw some patients making it out. Some of them stayed for a very long time in ICU, for more than two months. And we had their photos and letters from their relatives hanging around their beds, telling us the stories of who they were and making us seeing them as people who had their lives outside the hospital. It was one of the happiest feelings knowing someone had made it out and was now on their way to recovery. Personally, I have also learned to enjoy the little things and how to look after myself. I do hope, though, that 2021 is better than last year. As much as I learned last year, I don’t wish to repeat such an experience.

MARCIA ALMANZAN Staff Nurse, Respiratory HDU I started working at OUH last February, I guess you could call me a ‘newbie’. I would like to consider myself one of the lucky newcomers though, as I started working at the JR and still had the chance of a proper supernumerary. After almost two months of getting acquainted with the city and new work colleagues, coronavirus was looming nearby. It felt like all of us were living in a science fiction movie. We were hearing about the pandemic on the news on a daily basis, people hoarding basic necessities and most of all, that chaotic scene in the hospital. As much as we don’t want the public to panic, the whole world needs to know this is real and has a mission to teach us the uncertainties of life. As healthcare professionals, we all do have the obligation to care and at the same time not cause any panic to the general public so we try to put our brave faces on. But we too are humans, I bet each and every single one of us working in the hospital have our own stories to tell. I don’t know if we’d all like to be called heroes but all NHS staff need to be reassured that each and every one of us is doing an amazing job. I would like to acknowledge my team in the Osler Chest Unit. Being part of this Respiratory High Dependency Unit, many had been asked to challenge themselves.

We had to move to three different locations in the hospital to cater to the growing numbers of COVID patients, new staff members had to learn different modes of non-invasive ventilation faster as we were to impart that knowledge to other OUH staff members who were only redeployed to our area due to different circumstances. Similar to the ever changing UK Government guidelines, our hospital protocols changed every three days and my team was very adaptive to these challenging conditions. From patients saying their goodbyes over the phone or via video call in the last moment of their lives to struggling with the anxieties of catching the deadly virus ourselves, we have seen it all. To prioritise those who care for patients who have COVID, I am grateful I had my first dose of the vaccine and we all would like to be hopeful that this is the beginning of things going back to our normal. I do hope the new normal will be as close as our own versions of our previous normalities. To travel and visit our families abroad and to see each other’s smiles that we all have been hiding for some time under our masks. I honestly felt scared many times but being part of the Osler Chest team for a year now made me feel that I am not alone. I am thankful that I am working with very skilled, industrious and supportive people. To quote a Disney movie, “There is no courage without fear”.

Manjinder Thiara – Staff Nurse John Radcliffe Ambulatory Assessment Unit © Oxford Medical Illustration (OMI)

Chapter 4 BAME staff stories

Black, Asian and Minority Ethnic (BAME) communities across the UK have been disproportionately affected by COVID-19. We invited prominent voices from our OUH BAME Staff Network to share their reflections about their personal and professional experiences of COVID-19, and the broader context of its impact on BAME communities in Oxfordshire and beyond.

BAME staff stories 2020 was not only the year in which the world faced up to a global pandemic but also the year in which the Black Lives Matter movement raised global awareness and consciousness about racial injustice and forced countries outside the US to grapple with racism within their own societies. We are grateful to our BAME staff colleagues for sharing their reflections, which provide much food for thought.

x FROM LEFT: Reema D’Souza, Sam Foster, Francesca Ridley, Ariel Lanada and Lindley Nevers. © Oxford Medical Illustration (OMI)

Shift in normality – unforgettable era by REEMA D’SOUZA Matron – Acute General Medicine Co-Vice Chair, OUH BAME Staff Network It won’t be inaccurate to say the past year has been the most extraordinary one in all our lives. COVID turned the entire world upside down. Globally, over two million people dead; economies on the brink of collapse; healthcare systems stretched to their limits; unemployment; separation from families for months, and not to mention supermarket queues and the ridiculous toilet roll wars. There are innumerable, almost forgotten people. When I read the stories of staff on ships aimlessly waiting for weeks onboard, unable to disembark, even when the ship has docked in the harbour, it made me realise this pandemic has not just affected office-going people with their commutes or families with children being homeschooled. I was tormented to watch videos from India where millions of unemployed migrant labourers, in procession, walked back to their villages from cities, for hundreds of kilometres in the burning hot summer sun, abandoning their worn-out shoes and walking barefoot on the roasting tarmac. Any calamity or misfortune, be it a civil war, natural disasters, or economic downturn, exposes hidden inequalities in our society. COVID has done just that. With a bit of endurance, most of us are coping, just. But there are families, individuals, and communities for whom this is a terrible time, and their stories and experiences are mostly unheard of. When the media calls our attention to them, it becomes our collective responsibility to seize those moments of discovery and work on them to make this world a better place.

Looking on the positive side, there are endless stories of kindness and people going beyond their capability or authority to help others. It might be our neighbour helping someone out or the local charity assisting individuals in coping with domestic abuse. Countless individuals throughout the world have made a silent but tremendous effort. There are also people we have learned about from the media, who have used this opportunity to make things better for everyone. Two names come to mind. The great Captain Sir Tom Moore’s contribution brings tears to my eyes. An elderly gentleman, a World War Two veteran, an extraordinarily positive man, who garnered the nation’s attention and united us all together to contribute £32.7 million from over 1.5 million supporters, just before his 100th birthday! How exceptionally impressive is that! The second individual is Marcus Rashford. Just 22-years-old, a Premier League footballer, who used his platform as a political activist and philanthropist to campaign on the issues of homelessness and child hunger. He used his personal experience as a child of growing up hungry, to make a difference to thousands of school kids who were nearly forgotten in this pandemic. How extraordinary is that! Both these individuals couldn’t be more different but they both contributed their personal time and effort and made a difference to other people’s lives. If there is anything the pandemic has taught me, it is this: we can all make a difference through our own little ways to better our society and the world as a whole! 85

Combating misinformation in our communities during COVID-19 by IMAM MONAWAR HUSSAIN Muslim Chaplain The last 12 months have been unprecedented and extraordinarily challenging, in terms of my work in the Trust and the wider community. In the Trust, as someone in the vulnerable category, I have worked remotely for most of the year. This has meant learning fast how to use the various virtual platforms to support our patients, their families and colleagues. During the first couple of months of lockdown in March 2020, there was misinformation circulating via social media suggesting that there would be forced cremations. This raised a great deal of concern amongst the local Muslim communities. I organised a Zoom meeting with the local Muslim communities and reassured around 100 attendees that this was not the case. In the wider community, I have produced a series of videos to help disseminate information relating to COVID-19 to our diverse communities in all the major local languages. In particular, during the Eid celebrations in 2020, I invited Civic and Faith leaders to record congratulatory messages, but at the same time emphasised through the videos the importance of adhering to Government guidance. In order to help celebrate Eid virtually I organised a Global Eid Celebration, which included live performances from major musicians from Pakistan, Bangladesh, Canada, USA, Senegal, 86

Sudan, Jamaica and the UK, with a virtual audience of 5,500 people. I have also worked closely with Oxfordshire Clinical Commissioning Group to produce messaging in the winter of 2020 promoting the importance of flu vaccination, again delivered through the generous support of local Faith and Community leaders, in different languages. One thread that has been constant throughout the pandemic has been one of misinformation and, as we move into 2021, this has not changed. In order to combat this, I have worked closely with our Trust Communications team to deliver COVID vaccination messaging in different languages and the Chaplaincy team took a lead in organising a significant community webinar entitled ‘Facts about COVID Vaccines’. I was vaccinated on the second day of the rollout for staff and used that opportunity to highlight this to the Muslim community via social media and Pakistani satellite channels. Despite all the hardships of the last year, I am immensely proud to be part of the OUH NHS family. I have witnessed first-hand the professionalism, compassion and excellence with which colleagues have cared for patients and their families, in the most difficult of circumstances. When loved ones remember those they lost, they will also remember the love and dedication with which colleagues, often complete strangers to them, cared for their loved ones. A great testament to all in this Trust and the NHS. PICTURED ABOVE: Monawar receives his COVID-19 vaccination from OUH Chief Nursing Officer, Sam Foster

Adaptive leadership amidst the COVID-19 pandemic by ARIEL LANADA Divisional Lead for Practice Development and Education, NOTSSCaN Division Chair, OUH BAME Staff Network I am sure that all of us are reflecting on these very difficult and challenging times, shaking our heads and wondering how long is this going to last, how much more do we have to deal with in this pandemic? In 2020, I lost a couple of my close Filipino friends and colleagues at OUH due to COVID-19. At that time, around 40 members of our Filipino Community of Oxfordshire were COVID-19 positive and needed to be at home quarantined. That was the toughest part of my life both as a nurse and as Chairman of the Filipino Community of Oxford (FilCom Oxford).

Francesca joins OneTeamOneOUH to support BAME staff A brand new role has been created to support BAME staff working at Oxford University Hospitals – thanks to the support of NHS Charities Together. Francesca Ridley joined our #OneTeamOneOUH in January 2021 as the Trust’s new Wellbeing Lead for BAME Staff following a successful grant application by Oxford Hospitals Charity. She said: “I’m not BAME myself and don’t have that

While our community was shaken, our faith and resilience were not. We needed to help and support each other. We set up a COVID-19 WhatsApp group to reach out and monitor our members. We started regular prayer meetings, and bought and delivered groceries to those who were in home isolation.

lived experience, but I want to be a strong ally. What

As a community, we reached out to our network including Oxford City Council and Oxfordshire County Council and distributed, over several weekends, a total of 1,200 hot meals to our colleagues at OUH across the four hospital sites.

is Matron for Acute General Medicine, said: “We are

I do have is a drive to learn, understand as best I can, and speak up about the inequalities which our BAME colleagues can face every day, and have been highlighted even more so during the pandemic.” Her new role was welcomed by the OUH BAME Staff Network whose Co-Vice Chair, Reema D’Souza, who excited to work with Francesca very closely. We are keen to support our staff with their emotional, psychological and mental wellbeing. This role is key to reaching out to everyone who is struggling emotionally or mentally, or who want to support each

…continued on page 88

other, so we can provide a network of staff to either seek support or to provide support.”

As a Divisional Lead for Practice Development and Education at OUH, I needed to act fast and decisively. I trained the majority of our Clinical Nurse Educators in PPE level 1 and 2 and together we trained more than 2,000 staff including porters and domestics in just a few weeks.

On 27 January 2021, I received my first dose of a COVID-19 vaccine. One of the most effective ways of protecting myself, my loved ones and the public in general. So there is hope. I believe there is an end in sight and I am hopeful that the end of this pandemic is near.

No doubt, COVID-19 has taught us a lot of lessons in life. I have learned three ingredients to fight against this pandemic.

Adaptive leadership to me is the ability to be flexible and to be conscious of changing circumstances, to get things done with and through others, with new and existing members of the team and together, with a common purpose, come out triumphant at the end. Yes, by working together we can save lives, we can help the NHS and we will defeat COVID-19.

First, ‘willingness’. Willingness to ask and accept help. Willingness to go the extra mile. Willingness to be more compassionate, understanding and kind to each other. Secondly, ‘tenacity’. The tenacity to keep going and not give up. Rest if you must, but do not give up. Amidst complexities and overlapping deadlines, keep fighting, our goal is to reach the finish line together. Thirdly, ‘resilience’. The ability to reflect and learn from our mistakes. It is normal to feel you are not OK sometimes, but life must go on. COVID-19 has taught us lessons that we never learned in school. We are using technology more than ever and we are much more connected than ever before. The whole country stood together to fight against this pandemic. Many voluntary organisations were created and networks established. COVID highlighted some of the issues that possibly we would never have learned about without it.

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COVID-19 changed the world for us in 2020 by LINDLEY NEVERS Head of Finance – Investments and Oversight Co-Vice Chair, OUH BAME Staff Network As 2019 came to a close, the news of a potentially deadly coronavirus emerging out of the then little known provincial city of Wuhan in China gave us very little pause for thought on the optimism many of us held for 2020. This was an epidemic in China, as the disease spread in Wuhan, prompting a lockdown of that city in early January, deaths were reported, new mega hospitals were being built: the deadly virus was real yet it was distant from our shores. By February, COVID-19 became the new name for the coronavirus, and we had reported our first death in the UK from a disease which was now declared a pandemic. The virus had reached our Isles and had taken hold in other parts of Europe. A cough from a colleague sitting next to us would be cause for panic as we swiftly created our distance. Community spread by early March meant learning new techniques for washing hands for over 20 seconds, discovering that ‘happy birthday’ could be sung twice over that period of time, and being socially distanced meant being at least two metres from our close friends and family members outside of our households. Later that month came the national lockdown that changed everything – we now had to stay home. The seriousness of this disease really began to impact us.

We had to work from home. Working from home wasn’t new to me, but this was not once per week, it was now every day. This was novel at first but became isolating over time. Schools were closed and we now had to home school our seven-year-old daughter, and this was an added dimension to the new dynamics of working from home. Like many other families, our new realities changed our family dynamics for better and in some respects for the worse. We had to learn the new rules of living together for 24/7 at home with no other in person interaction for weeks. We learned to use Teams and Zoom for our work and social interactions. No meeting was complete without asking about the background noise or asking a colleague to unmute. We were introduced to our colleagues’ personal space, their dining rooms, kitchens, bedrooms and studies. We became familiar with their pets and children and sometimes jealous of the teas and coffees their partners brought them during our calls. Moved by the commitment, dedication, the selflessness and sacrifice of our frontline staff I would not have passed up on the opportunity to volunteer on Saturday mornings at the JR Charity Hub supporting the logistics for distribution of meals and care packages to staff working at the front line of our COVID-19 response. Don’t forget our Clap for Carers, another national expression of gratitude to our NHS heroes and careers, and yet another addition to our otherwise scant social diaries.

The human cost reflected in rising rates of hospitalisation and deaths was real and much closer to home as I began to know people who had become severely ill from COVID, from my work colleague who had ended up in ICU and losing her mother, to having myself lost a former classmate, a clinician in New York. I had also lost a cousin and an uncle as well as family friends. The new reality was a world and a country united in grief at the loss of loved ones, united in crisis that only few could claim not to be affected by. The daily 5pm Downing Street COVID-19 briefing became almost must see TV, except that it relayed mostly grim news as it continued to count the human toll. It also became apparent that people from Black, Asian and Minority Ethnic (BAME) communities were disproportionately impacted by the more severe illness and deaths due to COVID-19 which raised real concerns and anxieties about our vulnerability to the disease. This prompted a requirement from NHS England for all NHS BAME staff in England to be risk assessed. COVID-19 exposed some of the racial inequities within our society and the extent of our communities’ occupational exposure to the disease. Whilst the society grappled with a response to this unfolding evidence of health inequality, the world news headlines suddenly shifted from COVID-19 to focusing on systems of racism across the pond. The world was shocked by images of a police officer’s knee resting on the neck of George Floyd as he drew his last breaths whispering “I can’t breathe”.

This brutality towards a black man sparked global condemnation and protests which spread across the world, forcing people to reckon with systems of racism within their own countries. The advocates and allies found purpose beyond the immediate concerns of the pandemic to join voices in the impetus to effect positive change as far reaching in its impact as COVID-19 itself, and for leadership in addressing systematic racial injustice and inequalities. COVID-19 had not gone anywhere but the national lockdown was replaced by regional tier restrictions, and then more national lockdown and then again with regional lockdown with even more tiers. Vaccines developed at pace were now being authorised for use in the fight against the invisible enemy. With rollout which began in early December, we were beginning to see an escape, the light at the end of the tunnel from the social restrictions we had endured, but nevertheless Christmas was going to be like none other we had seen in our lifetime. The promise of a fiveday reprieve over Christmas so we could spend time with our loved ones was commuted to just Christmas Day for some and zero days for others as a new variant began to take hold. 2020 and COVID-19 represented a year of profound change for most of us, a year that at the beginning no one could have predicted would have ended in ‘tiers’.

Trust Board commitment to equality, diversity and inclusion Terry Roberts, OUH Chief People Officer, and Dr Bruno Holthof, OUH Chief Executive Officer, wrote a personal message to all staff in June 2020 on behalf of the Trust Board to reaffirm their commitment to equality, diversity and inclusion at OUH. “Throughout our response to COVID-19 at OUH, our strength has been in our common purpose and togetherness. It has been exemplified in the hashtag we have used when sharing stories about you, our extraordinary staff, and the patients who depend on us – #OneTeamOneOUH. “That togetherness and that sense of One Team is rooted in the diversity of our workforce. That diversity is one of the strengths of the NHS in general and OUH specifically. “Now, more than ever, it is important for us to pull together as we see the shocking scale of racism which is still sadly prevalent in society today, and as we discover more about the disproportionate impact which COVID-19 is having on people from BAME communities – including our staff. “We recognise that our BAME staff colleagues may be feeling a heightened sense of anxiety, vulnerability and indeed anger at this time. And that is why today we are writing to you on behalf of the Trust Board to reaffirm our commitment to equality, diversity and inclusion here at OUH.

TERRY ROBERTS Chief People Officer

DR BRUNO HOLTHOF Chief Executive Officer

“We are taking action to address inequalities including, importantly, ensuring that inclusive recruitment is a key part of the training which we provide to those managers who recruit new staff to join our team at OUH. “We also want to ensure that BAME staff have a stronger voice in the organisation – if you would like to get involved in our Staff Network please contact Tommy Snipe (Equality, Diversity and Inclusion Manager). “We will not tolerate racism or harassment of any kind at OUH – and so our Respect and Dignity at Work Procedure is in place to ensure a zero tolerance approach to unacceptable behaviours. “We know that as a Trust there is much more we need to do – and the Trust Board is committed to driving this work forward with all staff at OUH.”

Isabelle Speight and Philip Ike from the Ambulatory Assessment Unit share their thanks with our local community © Oxford University Hospitals

Chapter 5 Behind the front line

In spring 2020, we launched an internal communications, social media and website campaign to publicly thank some of the staff teams, volunteers and partner organisations who worked tirelessly to support frontline staff at OUH during our OneTeamOneOUH response to the COVID-19 pandemic. The campaign specifically focused on teams which the public and even some staff colleagues may not be aware of because their work ‘behind the front line’ is not always so visible. Here are a selection of these Thank You stories.

Linen Team On Level 0 – the basement – of the John Radcliffe Hospital’s main building, you will find the Linen Room, home to our Linen Team. This is the team responsible for the freshlylaundered bed sheets, the blankets and pyjamas essential for the daily bed and linen changes that keep our inpatients safe and clean. They also run a staff uniform service for clinicians and nurses, which was extended during the COVID-19 pandemic to include co-ordinating the provision of clean scrubs. The Linen Team is part of the Estates and Facilities ‘family’ (their own description) which includes (among others) the teams responsible for our waste disposal and recycling, postal services, and the maintenance of hospital grounds. 94

The Linen Team works very much behind the scenes, and its workers are not normally noticed by patients or the public, who see clean bed linen appearing on the wards as if by magic! The past year has been an extremely busy one for the Linen Team – especially so during the early days of the COVID-19 pandemic, and some staff worked extended hours to ensure that patients and staff on the wards had all the items they needed.

HR Teams – Resourcing, HR Records and Workforce Informatics Our Resourcing Team includes General Recruitment, Medical Staffing, Work Experience, Voluntary Services, and Retire and Return. It doesn’t take a lot of imagination to realise how much their workload was impacted by the COVID-19 pandemic, which meant, among many other tasks, prioritising recruitment to COVID-19 related job roles and candidates, enabling student nurses and medical students to work in the Trust, redeploying medical staff to where they were most needed, and matching volunteers to tasks. The HR Records Team and the Workforce Informatics Team are also key teams in the Trust with the important task of making sure that our staff are properly employed – and paid – whose workload was also massively impacted by the COVID-19 pandemic.

The Workforce Informatics team also took on additional reporting duties during the pandemic and both teams worked remotely and flexibly, adapting to new electronic processes and forms, which came with a number of challenges, and did so tirelessly in order to get the job done. Terry Roberts, OUH Chief People Officer, says: “When you come into hospital, the nurses and doctors are visible, but you may not be aware of the many vital functions that go on ‘behind the scenes’. Without the hard work of these teams, and their willingness to go above and beyond, we would not have been able to respond to the COVID-19 crisis in the way that we have.”

Together, these teams embraced new and different ways of working to get these extra workers fully integrated into the Trust’s systems in a very short space of time. As well as their usual workload, the HR Records Team managed to add 576 new starters in March and April 2020 alone, including hundreds of extra workers who either joined, or returned to, the NHS to be part of our OneTeamOneOUH response to COVID-19.

Domestic Assistants Our Domestic Assistants are vital members of our OneTeamOneOUH because COVID-19 has brought an even stronger focus than usual on the requirement for the highest possible standards of cleanliness to ensure everyone’s safety on all our hospital sites. This wonderful team of dedicated staff, who have shown bravery and courage during this challenging period, have adapted their roles to ensure the best possible service for our patients and staff. 98

Our Domestic Assistants received some lovely comments and thank you cards from patients too. Anne Tutt, Vice Chair and Non-Executive Director of the Trust, says: “We would like to say a massive thank you to all these staff, for all their hard work and dedication. Their work, in partnership with the Trust, has been amazing.”

Digital Team A major part of the NHS response to the COVID-19 pandemic was a huge leap forward in the use of technology. At the Trust, all this falls under the remit of the OUH Digital Team.

Microsoft Teams has been used widely for team meetings, Trust Board meetings, virtual briefing sessions for staff with the Executive team and much more.

This team has worked flat out to supply the equipment and ‘back end’ systems that have allowed as many of our staff as possible to work from home. Homeworking brings particular challenges for the NHS, but work carried out by the team has allowed safe access to medical records, X-rays and other secure hospital systems from home for staff who need it.

David Walliker, OUH Chief Digital and Partnership Officer, says: “Digital is an essential part of any organisation, but in our Trust it is also an essential part of patient care. Without our Digital Services we could not run our hospitals or treat our patients effectively or safely.

Since March 2020, OUH clinical staff have carried out 100,000 video consultations with patients through Attend Anywhere, an NHS-approved video appointment service, and 300,000 telephone appointments.

The teams have risen to this challenge in an extraordinary way, and we really must thank them for that, because it has been a game-changer; and I’m very proud of what they have achieved.”

Reception Team Our Patient Services Reception Team is the ‘face’ of our Trust, and members of the team are often the first faces our patients see when they arrive at our hospitals – patients who may be anxious, worried, scared, stressed or angry. Our reception staff direct patients to their appointments, offering reassurance and kindness, ensuring they are comfortable while they wait in our reception areas, putting them at their ease. COVID-19 has brought many challenges. Patients have been more worried than ever, and it has been the team’s job to reassure them they are in safe hands. Our reception staff also provided support to the Complaints team and the Patient Advice and Liaison Service (PALS) team, and helped Oxford Hospitals Charity manage generous donations from the public and local businesses that have been arriving at our hospitals throughout this challenging time. Our patients often thank them for their friendly greetings and smiles, with some patients telling them “a smile is the best medicine”!

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Eileen Walsh, OUH Chief Assurance Officer, says: “It has been so important to ensure the continued smooth running of our hospital sites during this very difficult time. We are enormously grateful for the work of our receptionists. We really couldn’t manage without them.”

Practice Development and Education Teams

The onset of COVID-19 brought into even sharper focus the importance of training and developing our staff, enhancing their core skills, and preparing them for what was to come. This has been the responsibility of our Practice Development and Education Teams, who responded magnificently by reviewing and changing their day to day activities to educate and support our staff for the challenges they faced.

Other vital clinical skills have been taught too, for example the care of acutely unwell patients and those in intensive care, and refresher courses in the basics, such as venepuncture (taking a blood sample) and cannulation (insertion of a tube into a vein to give fluids and medicines). Sam Foster, OUH Chief Nursing Officer, says: “I am enormously proud of the work that our teams have undertaken across the Trust, which reflects the world-class reputation this organisation has for patient care and clinical education.”

Their many achievements included the training of staff on our ‘back to the ward’ programme and the training of staff in the correct use of Personal Protective Equipment (PPE). 101

HOUSEKEEPING TEAM

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Pharmacy Homecare Team Our Pharmacy Homecare Team supports clinical staff across our Trust by setting up, managing and supporting homecare services, to ensure patients can reliably receive their lifelong, life-supporting medication. During the COVID-19 crisis, they have set up new services so that vulnerable patients have not needed to come on to our hospital sites to collect their medicine. Early on in the crisis, when the #ClapForOurCarers events began on Thursday evenings, the team was very moved to receive messages from homecare providers, wishing them well and reminding them how all NHS workers are appreciated. Sara Randall, OUH Chief Operating Officer, says: “This team has done vital work, making sure patients have their much-needed medicines without having to leave the safety of their homes. It has been really inspiring to see how they have pulled together, with colleagues supporting one another through this difficult period.” The team operates alongside other teams in Pharmacy who have also been working extremely hard to ensure patients are safe, and get their medication when they need it.

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Voluntary Services Team and our volunteers Key to our COVID-19 response has been the work of our dedicated volunteers on all four of our hospital sites, delivering food parcels and other essentials to frontline staff. Following a fantastic response to our call for help, our Voluntary Services Team, with colleagues in Resourcing, carried out more than 90 preemployment checks, working beyond normal hours to organise cover seven days a week and to match volunteers to vital COVID-19-related roles. Each year, during Volunteers’ Week from 1-7 June, we would normally celebrate the contribution of our volunteers with a strawberry cream tea – a chance to get together, meet other volunteers and socialise. Volunteers’ Week 2020 occurred during lockdown, so instead the Voluntary Services Team arranged a lovely afternoon tea delivery to our volunteers’ homes.

This required expert co-ordination to ensure that deliveries were made safely. The positive feedback from this gesture was overwhelming, not least because some of our volunteers have been ‘shielding’ and have had limited contact with people. Our Voluntary Services Team worked effortlessly to ensure they did not feel forgotten, and that their contribution to frontline teams and patients, sometimes over many years, continued to be celebrated. Terry Roberts, OUH Chief People Officer, says: “The COVID-19 crisis has reminded us how much our volunteers contribute to our services, and we are fortunate to have such a welcoming and efficient Voluntary Services Team to take care of them.”

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Clinical Engineering Team From the start of the COVID-19 pandemic, it was clear that the availability of suitable equipment was going to be a key factor in delivering the very best care to our patients in hospital. For example, a bed in an Intensive Care Unit (ICU) needs highly specialised equipment, which needs to be continually changed and modified as the situation changes. The team responsible for this is Clinical Engineering which takes care of 50,000 pieces of medical equipment at OUH. Clinical Engineering staff have been on hand to ensure that all this equipment is safe, working and available to our wards and departments throughout this challenging time.

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Like many of our teams, they adapted to new ways of working, supporting Critical Care with an oncall service, as well as working over weekends and Bank Holidays to set up and deploy equipment and commission loan ventilators. In one weekend the team set up a 13-bed ICU from scratch. At the same time, the Oxford Vaccine Trial urgently needed patient monitors before the trial could begin. The team identified, set up and delivered these within 48 hours, getting the trial off to a flying start. Professor Meghana Pandit, OUH Chief Medical Officer, says: “The Clinical Engineering Team worked tirelessly during the COVID-19 pandemic to ensure that OUH had sufficient medical equipment such as ventilators, NIV machines, syringe pumps etc. They are a fantastic team and an asset to OUH.”

Occupational Health Team Our Occupational Health and Wellbeing Team’s ‘day job’ is dealing with workplace health concerns, which range from advice on supporting staff with health issues, sickness absence, physiotherapy, health surveillance and assessing fitness for work, to wellbeing training and immunisations. But in 2020 the team’s workload suddenly included the symptomatic staff COVID testing service, contact tracing for positive staff, and supporting the health of our workforce dealing with a global pandemic, as COVID-19 hit the UK.

“The health and wellbeing of our staff is paramount at all times, but never more than when we are faced with the huge challenge of COVID-19. “They have risen to the immense challenge of the pandemic and have done everything they can to keep our workforce safe and well, which means that our staff in turn can continue to provide excellent, compassionate care for our patients.”

Working closely with Infection Prevention and Control and Microbiology teams, they were joined by the Hepatitis C Community Team, retired and returning members of staff, research staff and medical students, all of whom kindly offered their help as demand peaked.

k you to our all-important Together, they joined forces not only to carry out the task of rapidly testing our staff, and estic Assistants, forhuge ‘bravery theirhigh household members, but also to provide ourage’ ensuring work-specific advice to thousands of staff with ards of cleanliness for regarding their COVID vulnerability. one’s safety inconcerns our hospitals.

Terry will get through thisRoberts, together”OUH Chief People Officer, says: “Our Occupational Health Team has made us all incredibly proud.

neTeamOneOUH

THANK YOU

for all that you do! , more than ever, we would like to say e Domestic Assistants, for the incredible work they do. You can read all our THANK YOU messages on the OUH website: www.ouh.nhs.uk/working-for-us/celebrating-staff/thank-you 107

CLAP FOR CARERS Rita Ramos – Senior Staff Nurse, Tom’s Ward

Chapter 6 With a little help from our friends

The COVID-19 pandemic has made the past 12 months a year of unprecedented challenges for everyone working at OUH but the way in which our local community has pulled together to support our staff and patients has been a real shining light. We only have space to highlight a selection of examples of the help and support which underpinned our OneTeamOneOUH response to the pandemic in this e-Book – a heartfelt thank you to every individual and organisation who played their part.

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Oxford Hospitals Charity Oxford Hospitals Charity has played a key role in supporting OUH staff and patients, and co-ordinating offers of support from our local community, throughout the COVID-19 pandemic. We owe a special thank you to our friends at the Charity for leading and funding so much of this directly and for managing many of the generous offers of support and assistance which we received from our community, during both the first and second waves of the pandemic.

Sam Foster (Chief Nursing Officer, OUH) is pictured with Douglas Graham (Chief Executive Officer, Oxford Hospitals Charity)

Professor Sir Jonathan Montgomery, OUH Chair, says: “We were overwhelmed by the support of our local community, right from the start of our COVID-19 response. Had it not been for the help provided by Oxford Hospitals Charity, and their supporters, we would not have been able to look after our staff as well as we have, enabling them to provide the best possible care for our patients.” As early as 19 March 2020 – before the first national lockdown – the message from the Charity was clear: “Oxford Hospitals Charity has always been there for the incredible NHS staff working across the John Radcliffe, Churchill, Horton General, Nuffield Orthopaedic Centre and Oxford Children’s Hospital. But in these unprecedented times the need for our work is greater than ever.

Horton General Hospiital Hosp

Charity Horton General Hospiital Hosp

Charity

Charity activity packs have made a big difference to patients

“We are liaising very closely with the Trust to ensure that we are able to give extra support to hospital staff and help in whatever way we can. This starts with little things like pizzas, drinks and snacks to provide quick and easy refreshment for teams working in extraordinary circumstances. Care packs are being delivered from today.

Horton General Hospiital Hosp

Charity

Horton General Hospiital Hosp

Charity

“We are also co-ordinating many of the offers of help coming in. We know many people are thinking of the NHS staff here, and that means a lot. We have to ensure that support is carefully managed and people do not come to the hospitals unnecessarily.”

Horton General Hospiital Hosp

Charity

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The Charity encouraged people who wanted to help to make a donation on their website, so they could act quickly to fund whatever was most needed, and urged local businesses and others with practical offers of support to get in touch with the Charity. The Charity’s message concluded: “Going forward there is going to be much that we need to do. And we hope you will be able to help in this mission. We are incredibly inspired by the efforts we are seeing from staff across the hospitals.” During the second wave the Charity continued to reach out to teams and departments across the whole Trust, working alongside volunteers to provide fresh fruit, care packs and treats. The need for extra psychological support and calm non-clinical spaces became clear, so they Horton created respite spaces and funded specialist roles General Hospiital Hosp which will help OUH staff in need of extra support Charity going forward. Horton General Hospital Hospi

Throughout the whole year equipment to help Charity virtual monitoring of vulnerable patient groups was also funded by the Charity. Patients were at the forefront of their work – especially whilst visiting was severely restricted.

Horton General Hospital Hospi

Charity

Horton General Hospital Hospi

Charity

One of our patients enjoying a virtual music concert

Virtual music concerts were performed live for individual patients, giving a huge boost, and hundreds of patient activity packs, with puzzles, quizzes and activities, made a difference. 12 months on, we would like to thank the Charity and its dedicated staff for everything they have done – being by the side of our OneTeamOneOUH staff every step of the way.

Horton General Hospital Hospi

Charity

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Charity Support Hubs were a real team effort Volunteers, OUH staff and members of the Oxford Hospitals Charity team worked together to bring extra support to staff on all our hospital sites during spring and summer 2020. So very many generous offers were received from local people and businesses that Charity Support Hubs were created on each hospital site to coordinate the meals, refreshments and care packs being donated for our staff. Over the weeks, thousands of meals were provided every day for staff working round the clock during the peak of COVID-19. Hazel Murray, Head of Programme at Oxford Hospitals Charity, who worked alongside the Trust to create and co-ordinate the Hubs, says: “It was clear very early on that there was a real need to offer practical help to staff, especially with restaurants and cafés closing and shops in short supply of basics. “The Charity decided a series of Hubs was needed to practically manage donations coming in and then get that support out – and we asked Voluntary Services and the Trust to help find us people to work on the ground. “The volunteers have been absolutely amazing – I simply can’t praise them enough.

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“They have turned up with smiles on their faces and a can-do attitude day after day. Some were students, some furloughed staff from local businesses, and others just concerned local people who wanted to make a difference. “I’d also like to really praise the members of OUH staff who volunteered to help manage the Hubs; again, there was a really positive approach, with problems solved and practical solutions found every day.” Support was extended to staff staying close to the hospital sites in hotels, with regular fresh meals delivered daily, and some meals were also delivered to staff unwell at home. Hazel says: “I am incredibly proud of what the whole team achieved. It’s really great to have the chance to say a proper ‘thank you’ to all those involved, who gave up so much of their time to help provide this support to thousands of staff. “We are also incredibly grateful to the many, many local businesses and groups who helped us on a daily basis. Their generosity was simply extraordinary.”

Natasha Weibel (Change and Effectiveness Lead, NOTSSCaN Division), flanked by Charity volunteers Tamara Moon and Amy O’Hanlon, in the Charity Support Hub in the West Wing at the John Radcliffe Hospital

Members of the team in the Charity Support Hub at the Horton General Hospital including Bridget Daly (Voluntary Services Co-ordinator – holding the Charity sign) and Yolanda Jacob (Horton Operational Manager – seated)

Jabeen Alam (Admin Officer, Orthotics) and Suyin Mills (Directorate PA) in the Charity Support Hub at the Nuffield Orthopaedic Centre

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Thank you to Salute the NHS In the early days of the COVID-19 pandemic, Ron Dennis (founder of McLaren Group in the world of motor racing) and Nigel Harris (owner of Absolute Taste) joined forces with major companies including Tesco and delivery firm Yodel to launch Salute the NHS with the aim of providing free and nutritious meals to NHS staff. The national initiative was launched at OUH in early April 2020 and just three months later Salute the NHS had delivered more than 100,000 meals and care packs to OUH hospitals alone, which were made available via the Charity Support Hubs run by OUH volunteers, staff and members of the Oxford Hospitals Charity team. Speaking in late June 2020, OUH Chief Finance Officer Jason Dorsett said:

“I would like to share our sincere thanks with the Salute the NHS team and partners, for their tremendous support of our hospitals during the COVID-19 pandemic. “The Salute team came to OUH in the very early days of COVID-19 with a real understanding of how staff on the front line were being affected and with a generous and thought through offer of help. “We were delighted to be the first NHS trust to benefit from the Salute programme and have heard numerous accounts from our staff about what a difference it has made, providing a much needed boost to raise both morale and energy levels during difficult days. We will always be grateful.”

PICTURED ABOVE: Jason Dorsett (Chief Finance Officer – 3rd left) and Florian Stoermer (Divisional Director of Nursing, NOTSSCaN – 4th left) with Hazel Murray (Head of Programme, Oxford Hospitals Charity – 4th right) and colleagues at the Salute the NHS depot in Bicester

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Project Wingman took off at OUH An initiative by staff furloughed from the airline industry during the COVID-19 pandemic gave a real boost to staff working at both the Horton General and John Radcliffe hospitals in summer 2020. Project Wingman volunteers – grounded flight and cabin crew staff – used their experience of working in stressful and pressured environments to help staff unwind during breaks from shifts. They served refreshments and chatted with their guests, drawing on their training in compassionate listening and stress reduction techniques to help staff relax. It launched at both the Horton General and the John Radcliffe hospitals in June 2020 with refreshments funded by Oxford Hospitals Charity and provided by Carpenter Catering.

Terry Roberts (Chief People Officer) with OUH staff and Project Wingman volunteers at the John Radcliffe Hospital (above) and the Horton General Hospital (below)

Pilot Emma Henderson, co-founder of Project Wingman, said: “We founded Project Wingman as the airlines were starting to ground crew, to support NHS staff both emotionally and practically in extraordinary times. We wanted to provide, as far as possible, a distraction from their primary role by utilising uniformed airline crew with their amazing people skills.” Thank you to all the Project Wingman volunteers who gave up their time to help support our staff.

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Thank you to all keyworkers

ur all-important tants, for ‘bravery nsuring high eanliness for ty in our hospitals.

In a personal message published in the Oxford Mail on New Year’s Eve 2020 – at the end of a long and draining year – the Trust Chair, Professor Sir Jonathan Montgomery, thanked our local community for their support and highlighted the crucial role played by all keyworkers: “Team Oxfordshire includes the army of other keyworkers whose phenomenal efforts and personal sacrifices don’t always get the recognition they deserve – from teachers to bus drivers, from the people who collect our rubbish

rough this together”

and recycling to the staff in our supermarkets. “And it includes everyone who supported our staff and our NHS in 2020 – maybe you took part

mOneOUH

in the weekly Clap for Carers, made a generous donation to our own Oxford Hospitals Charity or

PROFESSOR SIR JONATHAN MONTGOMERY Chair, Oxford University Hospitals

to the national NHS Charities Together, showed your support with a ‘Thank You NHS’ poster or rainbow in your window. We are so grateful for your support, which means a huge amount to

THANK YOU

our staff. an ever, we would like to say “The NHS locally for and nationally had lots of ic Assistants, the has incredible workfor they do. part of being thank yous this year, but I’d like to say thank

you on behalf of our staff to you – the people of Oxfordshire.”

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Team Oxfordshire!

Thank you to our on-site catering and retail partners Staff based on our hospital sites will know just how valuable our shops and food outlets have been throughout the COVID-19 pandemic – especially in the first lockdown. For example, the team based in the M&S Foodhall and Café at the John Radcliffe Hospital found themselves suddenly in ‘keyworker’ roles, with radical changes to their work practices, while maintaining long opening hours, seven days a week, serving staff working shifts. After suggestions from hospital staff, they even introduced a range of extra everyday items.

Carpenter Catering (Belota) staff in the GPEC Café at the John Radcliffe Hospital

We’d like to thank the whole M&S team for their upbeat cheerful attitude and efficient professionalism throughout the pandemic, and for providing such an important service. Similarly the Carpenter Catering team has really gone the extra mile over the past 12 months – their café in the George Pickering Education Centre (GPEC) at the John Radcliffe Hospital has been a haven for staff to rest and refuel during the pandemic. They extended their opening times from 6am until 7pm during the first national lockdown in the evening, and started opening at weekends, while also delivering daily staff packed lunches to COVID wards, and they also extended their role to the restaurant at the Horton General Hospital.

Staff outside the M&S Foodhall at the John Radcliffe Hospital

Thank you to M&S, Carpenter Catering and all our on-site retail and catering partners across all OUH hospital sites for being part of our OneTeamOneOUH!

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Formula 1 nurse and other staff who returned to the front line Hundreds of staff including nurses, doctors, midwives and support staff were recruited to join our OneTeamOneOUH workforce in the first wave of the COVID-19 pandemic through NHS Professionals’ Rapid Response scheme. We are so grateful to these returners, many of whom hadn’t worked in the NHS for many years, who answered the call and returned to the front line to support patients and our existing staff. They included Su Chantry, who had last worked as a Neonatal Critical Care Nurse at the John Radcliffe Hospital 15 years ago before she returned to work at the JR again in March 2020 – this time on the general medicine, orthopaedics and acute respiratory wards with COVID-19 patients.

Su was working as an Occupational Health Manager at Williams Grand Prix Engineering in Grove and in her own occupational health business before the COVID-19 pandemic struck. With her clinical work being paused due to infection control measures and a national call to all registrants to assist in the NHS, Su didn’t need to think twice about returning to work in the NHS. Andrew Carter, Director of Nursing – Workforce, says: “It is invaluable that we were supported by committed former colleagues such as Su to provide the best care possible to COVID-19 patients. To those dedicated people who have returned to the NHS to help others – thank you.”

Nurse Su Chantry was one of many former NHS staff who answered the call and returned to the front line during the COVID-19 pandemic

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Apprentices stepped up to serve the NHS The working lives of many OUH staff have been turned upside down by the COVID-19 pandemic and this is certainly true of our apprentices, whose programmes of education alongside practical work experience had to change to adapt to the ‘new normal’. Our Apprenticeship team worked closely with all our apprenticeship providers to minimise disruption to our apprentices’ studies, and our education partners offered alternative ways of learning wherever possible. Paul Smith was a Nursing Assistant in the Emergency Assessment Unit (EAU) at the JR, undertaking the Pre-Registration Nursing Apprenticeship and studying for a Degree in Adult Nursing with the Open University, when the COVID-19 pandemic struck.

Sian said in May 2020: “I am coping fine with working from home. My tip would be to communicate with your manager if you feel overwhelmed, or to accept that other areas of your work may have to take a backseat during this pandemic.” Mark Statham, Director of Nursing – Nursing, Midwifery and Allied Health Education, says: “The contribution of our apprentices during these unprecedented times has been inspirational. Hearing of the contributions they made and their willingness to adjust to ever-changing needs truly reflected the values of the Trust, indeed OneTeamOneOUH.”

We have always seen our apprentices as integral to our core workforce, and to hear their inspiring stories makes us proud. Thank you to all our apprentices for being part of our OneTeamOneOUH!

EAU was a key clinical area in the response to COVID-19 and Paul said: “I would urge anyone in a similar situation to take advantage of the learning opportunities which these situations create.” Our Business Administration Apprentices, such as Level 3 apprentice Sian Meredith, also performed valuable work to support our COVID-19 response. Like many other staff, Sian had to adapt to working from home, new working practices and new duties. OUH apprentices Paul Smith and Sian Meredith

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Military staff deployed at OUH Members of the Armed Forces joined up with us in early 2021 to support our OneTeamOneOUH response to COVID-19. Initially based at the John Radcliffe Hospital, 42 military personnel from the Ministry of Defence (MoD) supported staff in both clinical and nonclinical roles. A total of 20 trained Combat Medical Technicians, who in their day job deploy on overseas operations and exercises as medics, supported the Cardiac and Thoracic Critical Care Unit (CTCCU) and Emergency Department. Meanwhile, 16 military staff took on non-patient facing roles.

Their tasks included stock management and assisting with donning and doffing of PPE, as well as general logistical and administrative work – and six discharge planners helped our teams to get patients home. Lieutenant Colonel David Butt said: “It is an honour to assist the brave NHS teams who have worked so hard to look after us so well during this pandemic. The NHS stood alongside us in Afghanistan and Iraq and we’re glad to be able to stand alongside them now.” The Oxford Hospitals Charity team helped to create an MoD Mess in the Tingewick Hall Foyer for the military staff to use as their base.

PICTURED: Sergeant Ryan McCann and members of his team in their base at the John Radcliffe Hospital

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University of Oxford medical students Part of our OneTeamOneOUH Like many other University of Oxford medical students, Madeleine Oliver volunteered to help out with the fight against COVID-19 at OUH. She reflected on her experience in an interview published on the University’s website in October 2020. How did you end up volunteering during the pandemic? When the medical school was closed and our course was suspended a lot of students got in touch with the course director to ask how we could help. Then in late March 2020 we were sent a list of jobs where we would be helpful. I felt really lucky, so many young people were sent home from university with nothing to do but I had something tangible to do. It was so easy to feel helpless at the height of lockdown and I was glad to have something to do. What job did you do? I actually did two jobs. The first one was working in ICU helping health workers to change their PPE. This is called ‘donning and doffing’. This was in a dedicated area outside the ICU. As doctors and nurses came out of areas where they had come into contact with COVID-19 we would doff their PPE in an infection-safe manner and make sure they were disinfected. The other role I did was working on staff research looking at the COVID-19 presence and antibodies in staff working at the hospital.

What was it like? During normal student life you don’t really have a set routine but working shifts of 7-7 or 9-5 it felt nice to have a routine. At the time it felt so normal but now when I look back it was quite strange. It wasn’t scary because the medical school only gave us jobs that were within our capabilities. In terms of the disease, being young I felt in less danger and living with other medical students I was less concerned about passing it on to someone I lived with. In all I was really pleased to be able to do something when everyone else was in overdrive. It was very sobering seeing people living with the impact of the virus. When it was really busy and we were helping with nightshifts, we helped some of the nurses with jobs like turning patients. It was very hard-hitting to see the reality of COVID’s impact on individuals. 123

Oxford Brookes University student nurses, midwives and allied health professionals At the Oxford School of Nursing and Midwifery within Oxford Brookes University, we are immensely proud of the role our student nurses have played in caring for patients throughout the pandemic. More than 130 final year nursing students have worked with patients at OUH and in other healthcare settings across Oxfordshire. The Oxford School of Nursing and Midwifery is a partnership between Oxford Brookes University, OUH and Oxford Health NHS Foundation Trust. Students have been supported throughout the COVID-19 pandemic by the University and OUH. PERSONAL REFLECTIONS from student nurse, SARAH QUINN “I’ve been working as a student nurse throughout the pandemic. I’m based at the John Radcliffe Hospital working on COVID wards mainly with older patients. My role has been varied – from comforting the scared and aiding medical staff with procedures to carrying out checks on patients both medically and emotionally. I have been looking after the needs of each patient as a whole person, from when they are admitted to the end of their journey with us. This might be supporting them before they go back home, or in those tragic circumstances where they do not recover, preparing them for their final farewell.

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“The challenges have been many. COVID led to a radical shake-up of how we nursed and cared for patients. One of the most profound changes was PPE, causing a physical barrier between patients and those caring for them. I found it especially tough caring for patients with confusion or dementia. Trying to reassure them whilst wearing a mask, apron, goggles and gloves is difficult as we look terrifying. And that’s just level one protection. “But I did learn how much you smile with your eyes. And even through a glove, the squeeze of a hand is still comforting. On one occasion I used British Sign Language to spell my name to a patient who was deaf. I remember how grateful they were for that moment of connection. “Writing poetry has helped me channel my emotions into something positive. It’s been a way of dealing with those heavy heart moments, working in such a challenging environment during this world-altering pandemic.”

Thank you to children of OUH staff Dr Bruno Holthof, OUH Chief Executive Officer, wrote to all staff in June 2020 to acknowledge how challenging lockdown was for everyone – not only at work but at home. He said: “I am writing to you today because I know it’s been really tough for everyone over the last few months of the COVID-19 pandemic, and I don’t underestimate the impact on your family life and your loved ones at home.

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ly busy ............ over th ............ e last fe ............ to help ............ w mon us take ............ ths an care of ............ d the pe . has be ople w I am w en wor ho riting depend king re to al on yo our Oxf ly hard us. u to sa ord Uni y a massiv versity e TH A Hospita NK YO ls (OUH You m U for be ) team ight no . ing pa t realise becaus rt of it, but e your you’re love an time w a d really suppor hen th import t is help ey com ant pa ing them e to w rt of or k. our te get th A hug, am rough a smile a really , a joke when tough or even they co me ho just as me mak king th es a m em ‘H That’s assive ow was why w differen your da e think ce. come in y…?’ of you to wor as part k and of our at hom do O such a UH fam e. fantas ily becaus tic job e they w ith out yo couldn THAN ur love ’t K YOU and su so muc good w pport h for ev ork an erything d stay you’re safe! doing at hom With ve e – keep ry best up the wishes

Dr Bru no Ho lthof Chief Ex ecutive Officer

“Staff have many different caring responsibilities – depending on your family circumstances – and I do understand how your job here at OUH can impact on the ones you love, both young and old. This can be particularly true of children and young people who have been affected by the huge changes brought about by COVID-19. “For those of you who are parents or carers, I want to take this opportunity to say a personal thank you to your children for everything they are doing to support you during this time. I have written a letter which you can print off and add in the name (s) of your child / children – it is available to download and print off from the Oxford Hospitals Charity website. Thank you to you all and, of course, your loved ones.” Copies of a specially printed book explaining COVID-19 to children, with illustrations by Gruffalo artist, Axel Scheffler, were funded by Oxford Hospitals Charity and distributed in the Children’s Hospital at the JR, Horton Children’s Ward, Oxfordshire Hospital School, and to many OUH staff who have children. The project, which was the brainchild of our Chief Nursing Officer, Sam Foster, was made possible by the generous support of Fineprint. You can listen to the audiobook on the Oxford Hospitals Charity website at www.hospitalcharity.co.uk/ouhchildren. 125

Mary Joy Garrett and Nichola Barson – Emergency Department Reception at the Horton General Hospital © Jon Lewis / Oxford Hospitals Charity

(Not)

the last word…

As we launch this e-Book … In April 2021, the COVID-19 vaccination programme has brought new hope and Prime Minister Boris Johnson has announced the roadmap for a gradual easing of lockdown restrictions over the coming months. Now that we are moving into the next, more hopeful phase of our OneTeamOneOUH response to the COVID-19 pandemic, it is a fitting time to reflect on the journey we have all been on over the past 12 months. We invited all teams and staff from across the Trust to submit their contributions for inclusion so that we could truly reflect the experiences of our people in their own words. We are so grateful to all staff who took the time and trouble to share their reflections and we hope you enjoyed reading their stories. We would welcome your feedback and your further reflections so please do contact our Communications team with your thoughts via covidquestions@ouh.nhs.uk

Thank you

128

#OneTeamOneOUH

Stories from the

COVID-19

PANDEMIC #OneTeamOneOUH

Published by Oxford University Hospitals with the kind support of Oxford Hospitals Charity