Changes are being made at Noble’s Hospital to ensure it is ready to deal with cases of Covid-19.

Wards have been reconfigured to provide bed spaces, elective surgery is suspended, out-patient clinics are under review, and there are severe restrictions to visiting.

In addition, changes have been made at Noble’s Emergency Department and there is an expanded role for Ramsey Cottage Hospital.

Elective operations are to stop at Noble’s to free-up space and provide clinical support for incoming cases of coronavirus.

Patients whose admissions have been cancelled are being advised directly by the hospital on a rolling basis.

Cancer surgery and urgent operations will continue as planned.

Patients in wards 1 and 2, the male and female surgical wards, are being transferred to other wards, freeing 40 bed spaces in dedicated wards for Covid-19 patients who need hospital care.

All other wards will remain the same as now. Doctors and health staff from the surgical wards will be redeployed to assist in the hospital’s response to coronavirus.

Outpatient appointments that are scheduled to take place in the coming weeks will be reviewed by a clinician and patients contacted to confirm if their appointment will go ahead.

To ensure consultations continue for as many patients as possible, individual specialities will consider how best to manage their own areas and this may see some clinics continue by telephone instead of face to face.

Reducing demand for outpatient services will release capacity of doctors and nurses to attend training in preparation for treating patients with coronavirus.

The Emergency Department at Noble’s is being expanded to provide a separate area to deal with suspected and confirmed Covid-19 cases.

Patients reporting to Noble’s with symptoms will be signposted to the new assessment area where they will be seen by a clinician who will decide whether they can go home, need to self-isolate or require admission.

This system replaces the coronavirus triage point which has been in place for several weeks.

A new 111 telephone help line to assist patients with suspected Covid-19 opened on Friday morning.

The line is a clinical not a general help line and people are urged to first complete an online assessment on www.gov.im/coronavirus which will determine whether or not they should call 111.

Only those people with symptoms associated with Covid 19 - a new continuous cough and a fever - should call, after completing the online triage form.

Serious medical emergencies will go, as now, to the hospital’s main ED entrance.

Development of the Private Patients’ Unit has been put on hold and its large number of individual rooms are to be turned into isolation rooms as a ’sensible precaution,’ Health Minister David Ashford said.

He confirmed that Noble’s has just six emergency care ventilators with others on stand-by but he dismissed the assumption that any Covid-19 patient admitted to hospital would require ventilating.

’That’s not the case. Different people present different symptoms. If you look worldwide at the 6% regarded as serious or critical, of those 6% only 2% would require any form of serious medical intervention such as ventilation,’ the Minister (pictured right) said.

’The remainder simply need to remain in hospital in an isolation area and be treated according to their symptoms.’

ED staff are coming under increasing pressure from people phoning and attending ED without symptoms requesting a test.

This demand is diverting staff from dealing with unwell patients so those without symptoms are urged not to attend but instead read the advice online at www.gov.im/coronavirus

Ramsey Cottage Hospital has become the receiving centre for all patients with minor injuries.

The Minor Injuries Unit (MIU) in Ramsey is open from 8am until 8pm seven days a week, staffed by a team of nurse practitioners skilled in the management of minor injuries and supported by an orthopaedic specialist clinician and X-ray facilities.

Serious injuries will continue to be dealt with at Noble’s Hospital ED.

Arrangements are being made to transfer patients who travel to Ramsey by bus, from the town’s bus station to the hospital, using the Connect Villages service.

Patients who need this transfer should let the bus driver know on boarding that they are heading for the Cottage Hospital, and the onward leg of the journey will be organised for them.

Visitors

Visiting has been severely restricted at Noble’s to prevent the potential spread of coronavirus.

Only immediate family who need to visit for critical reasons will be permitted and will require permission from the nurse in charge of the ward before entering.

Signs have been put up at the entrances to Noble’s and staff have been on hand to explain the current system.

It is suggested that friends and family keep in touch with patients via phone or video call.

Thie Bee coffee shop in Noble’s reception area is closed until further notice.

The Health Minister was not present at a press briefing yesterday (Wednesday) given by Chief Minister Howard Quayle and EnterpriseMinister Laurence Skelly.

Mr Quayle said they will be announcing a ’step forward’ on testing people in the island.

When asked if NHS staff members will be tested as a matter of priority, he replied: ’We’re following the standard rules on testing at the moment.

’We are doing testing as we speak, but we will be stepping that up in the very short term and we will be making an announcement once we have the full plan ready to roll out.’

There have been concerns about returning locums to the island and whether they are exempted from self-isolation.

Mr Quayle said: ’We’ve said that certain professions and certain working members will be key. The DHSC will be working up a strategy on how to deal with people coming back who are key workers.’

Mr Quayle said he would be happy to provide more information shortly.