Update on Adult Therapies and Health Sciences Services in Powys

All Powys Teaching Health Board therapy and health science services for adults (Audiology, Dietetics, Occupational Therapy, Physiotherapy, Podiatry, Radiography (X-ray and Ultrasound) and Speech and Language Therapy) are gradually reintroducing their normal services following the Covid 19 lockdown period now that plans have been approved by the Health Board.

Maintaining services during lockdown

Some services, have continued to operate throughout lockdown supporting patients with urgent issues.

These includes services like podiatry, for example has continued to treat patients with wounds and will start by seeing those patients who are considered to be at high risk in addition to those who have wounds, then gradually expanding to include other treatments while maintaining social distancing and other infection control measures.

The Physiotherapy service has maintained a remote telephone service for urgent referrals, as per guidance from NHS Wales.  Our physiotherapy teams have been contacting, assessing and offering treatment advice and emailing exercise video programs to patients.

Dietetics have also continued to assess and advise priority outpatients by telephone, and have now moved to start seeing routine patients, incorporating virtual clinics too.  Priority Inpatients have also be seen face to face throughout the pandemic when in the patients’ best interests’ and risk can be managed.

Audiology has continued to offer a hearing aid repair service and battery provision service throughout COVID19 but has carried this out by postal service instead.

Community Occupational Therapy and Physiotherapy have continued to support patients with their rehabilitation at home following appropriate COVID guidance and using relevant personal protective equipment.

X-ray have maintained a service for urgent referrals as per guidance.

Restarting our Services

During the lockdown period, services have been contacting patients by telephone or using new technologies such as video conferencing. This is a completely new way of working for both patients and clinicians. The learning from this has enabled services to review how we offer services for the future therefore to reduce the number of people coming into the hospital and ensure patients can still have their appointments safely, we have already moved some appointments to a secure telephone or video conferencing service called “Attend Anywhere”.

If an appointment has changed to a telephone or video conferencing consultation, patients will be contacted with a pre-arranged suitable time and a link explaining how to access their assessment when the appointment is booked.

• A telephone call involves a detailed discussion regarding the problem with a clinician.  Goals will be identified to help create a treatment plan, and patients will be given advice and education regarding their problem/diagnosis. 

• The video assessment, gives all the benefits of a telephone assessment but uses an online programme called ‘Attend Anywhere.’ This lets the clinician make some assessments via video to discuss and observe the problem.

• Patients will need to have:
  • an email address
  • Google Chrome or Safari Internet Browser, if you haven’t got this, don’t worry it can be downloaded for free. 
  • good internet access and a camera e.g. on a smart phone, tablet or laptop.

For more information and frequently asked questions please visit our Virtual and Online Services section or follow this link https://digitalhealth.wales/tec-cymru/nhs-wales-video-consulting-service/nhs-wales-video-consulting-service-patients

We have received positive feedback from patients who have recently had a video consultation.

The patient felt comfortable talking to someone they could see. They found it really helpful to see demonstrations of exercises and were able to talk about their problem.  The patient said they would give video a ‘thumbs up’ and would recommend to others. 

One of the physiotherapists said that ‘’The attend anywhere technology worked well.  The patient was waiting in the virtual waiting room at the time of their appointment and connected with no problem.  There were no sound or connection issues throughout the consultation.  The patient was able to adjust the position of their camera as needed to observe movements and exercises.  It was a positive experience all round’’.

Audiology have also been using Attend Anywhere video to demonstrate controls on new hearing aids and check patients are putting the hearing aid in their ear correctly.

All of our therapy services have been working hard to put plans in place to start a phased re-opening of routine services across Powys but the way our services operate may have changed to ensure we comply with Welsh Government legislation for social distancing and NHS Wales advice on infection control. 

We have temporarily adopted a ‘virtual first’ approach in many of our services.  We will soon be able to offer all urgent and routine patients either a telephone or video consultation, via Attend Anywhere if triaged as appropriate.  We will have limited capacity for face to face consultations due to strict infection control operating procedures in our hospital sites, but by using a "virtual first" approach we will be able to ensure that face to face appointments are available for those who most need them - for example because of their clinical needs, or because they are unable to use telephone and video technology.  We have reviewed our infection prevention and control procedures in clinical areas to ensure we maintain a safe clinical environment for staff and patients.. 

We are close to finalising our plans for re-opening routine services but unfortunately we cannot confirm a definite date at this time.  However, all of our therapy and health science teams across all our sites in Powys are working hard on the re-opening plans and are looking forward to being able to support the local population for their therapy needs very soon.

By restoring normal services gradually and in a variety of different ways, we hope to offer patients as much choice as possible while ensuring that it’s done in as safe a way as possible for both patients and staff.

Thank you for your patience during this time.