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Darent Valley Hospital BAME medics and staff to be assessed for Covid-19 risk

Hundreds of "high risk" NHS Trust staff members from BAME backgrounds could see their roles change or be told to shield as new guidance on workplace risk assessments come into effect.

Darent Valley Hospital Trust medical director Dr Steve Fenlon gave an update to Dartford council on the team's public health response to Covid-19 last week.

Darent Valley Hospital in Dartford saw the sharpest rise in cases of all Kent Trusts with more than 700 recorded to date
Darent Valley Hospital in Dartford saw the sharpest rise in cases of all Kent Trusts with more than 700 recorded to date

It follows a report by Public Health England report last month which revealed people from Black, Asian, and Minority Ethnic (BAME) backgrounds have been disproportionately affected by Covid-19 and prompted the government to launch an inquiry.

Mr Fenlon told councillors a regional risk assessment tool was now in place which would apply to approximately 1000 of its BAME staff, as well its the consultancy workforce where around 75% its workers are from an ethnic minority background.

He said: "That will determine the level of exposure effectively that those people are able to take on."

"There is emerging evidence about the disproportionate affect of Covid on those people and in particular healthcare workers."

"We have a significant number of people in that group," he said. "We will do everything we can to ensure they are not exposed to both excess risk and that they are all given adequate protection."

Darent Valley Hospital Medical Director Dr Steve Fenlon Photo: Darent Valley Hospital
Darent Valley Hospital Medical Director Dr Steve Fenlon Photo: Darent Valley Hospital

Labour Cllr Ricky Jones, who represents the Princes ward, asked what this risk assessment might look like for local healthcare workers.

Mr Fenlon explained risk assessments had been in place since the beginning of the Covid-19 outbreak in March and said much like the general population many members of staff received shielding letters at that time advising they stay at home.

"The next stage of the risk assessment is to identify what we call vulnerabilities," he added.

Initially this was similar to the response to influenza but this has changed as emerging evidence on the virus shows there are more at risk groups, including BAME people.

He said: "Once this evidence emerged we went back and redid their assessment tools so we could reassess people's vulnerablities."

The medical director went onto explain in some cases this could mean "minimal people contact altogether, let alone patient contact".

"Once this evidence emerged we went back and redid their assessment tools so we could reassess people's vulnerablities."

However, he added the use of PPE would allow them to balance the risk of vulnerability in different scenarios with particular individuals.

Overall it had been "quite a difficult and challenging issue to manage," he said and sadly many staff members have been affected with some becoming seriously unwell.

This included the sad death of Dr Tariq Shafi, 61, who was from an Asian background and worked at Darent Valley for 13 years as the hospital's lead consultant for haematology.

Sue Braysher, director at the Dartford, Gravesham and Swanley Integrated Care Partnership (ICP), also gave representations to the council and said the full data was not yet available.

"Both Public Health England and Kent County Council Public Health team are beginning to look through that data and feedback to us.

"But we haven't got the figures broken down yet and we only started collecting the data once we realised their was a more significant impact on the BAME population".

Dr Tariq Shafi, a lead consultant for haematology at Darent Valley Hospital passed away last month from Covid-19
Dr Tariq Shafi, a lead consultant for haematology at Darent Valley Hospital passed away last month from Covid-19

She added this would be "fed through" as soon as it was available.

Meanwhile, Mr Fenlon continued to give an update on the Trust's overall Covid-19 performance.

He reported Darent Valley in Dartford had seen the sharpest rise in cases of all Kent Trusts with more than 700 recorded to date which he said they still haven't completely explained.

Although the doctor suspected it was most likely "due to the proximity to London" which saw a much earlier and steeper rise in cases, adding "we developed a sweep out from London due to our bite in south east London".

The hospital had recorded its the first death on March 20 and has had nearly 200 since which was around more than double the number of deaths it would usually see at this time.

Mr Fenlon was asked by Cllr Laura Edie, who represents the Newtown ward, whether there was a link between excess deaths and high levels of pollution recorded in Dartford.

Staff at Darent Valley Hospital wearing the face shields made and donated by the 3D printing group to help those battling Covid-19
Staff at Darent Valley Hospital wearing the face shields made and donated by the 3D printing group to help those battling Covid-19

But the doctor responded to say there was not a "straight forward" link between incidents of respiratory illnesses and excess pollution.

He went on to explain there were many other factors which "play into chronic respiratory disease" including incidents of smoking, which he said was not high for this part of the county.

The doctor added "as much I dislike pollution" he couldn't attribute it as a main contributing factor behind excess deaths caused by Covid.

"Interestingly enough over the whole Covid period our levels of atmospheric pollution must have plummeted because the amount of traffic stopped completely."

He explained how intensive care capacity had been pushed beyond its limit during lockdown with it operating at around three times its usual limit of ten beds to just under 30 at the peak of the virus.

This, Mr Fenlon said, had put enormous pressure on the Trust with patients being referred from children's care services right up to elderly care and everything inbetween.

Kunjunjamma Babu, a Sister on Cherry ward, left Darent Valley Hospital after beating Covid-19
Kunjunjamma Babu, a Sister on Cherry ward, left Darent Valley Hospital after beating Covid-19

Despite this he said the Trust had also seen some "spectacular stories of survival" managing to survive very long periods on intensive care.

Kunjunjamma Babu, a nurse on the Cherry ward, was admitted to the hospital where she worked in April but was later given a guard of honour after she fought off the virus and left to recover at home.

"I think those successes and successes elsewhere have helped to sustain all of us through this," he added.

The Trust is currently redeveloping its clinical strategy in the short term to ensure it can continue to deliver "safe and effective services under the cloud of covid 19".

He said many of its underlining strategies would remain the same but others had been severely affected.

One positive change he said must continue is the reduction in patient and staff footfall with the hospital only admitting "patients that have to be there".

"Stopping visitors has been difficult but we must continue to do this to maintain spatial distancing,"

He also spoke of the difficulty of caring for dying patients when they could not see their families except in exceptional circumstances and on compassionate grounds.

"Stopping visitors has been difficult but we must continue to do this to maintain spatial distancing," he said.

Director of the Dartford, Gravesham and Swanley ICP Sue Braysher said one of the board's main priorities going forward was assessing the impact of Covid-19 on mental health.

This included creating a tailored package of support for NHS staff, survivors and the bereaved families.

"It is going to be a long term impact," she said. "There is the Covid survivors, especially the ones on ventilators and in intensive care, that will have all sorts of long term health needs going forward.

"Then there's also the bereaved families because they didn't get time to say their goodbyes and the whole thing has been quite frightening for them. They must be traumatised."

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