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Gold Command in Manchester during Covid-19 pandemic

Monday 21st September 2020

Gold Command in Manchester during Covid-19 pandemic

Eram Hussain, from the NECS Consultancy team talks about her time working with Gold Command in Manchester during Covid-19 pandemic.

Coronavirus… I was at home when I heard about it. I didn’t think much of it at first, and definitely did not anticipate the impact it was about to have on people across Greater Manchester (GM). By people, I’m not just referring to those physically affected by the virus, but also; key workers, staff working on the frontline and, equally important, staff working in the back office to keep our Health and Social Care system running.

GM established their command and control structure in response to the infectious pandemic, Covid-19, which was declared as a Level 4 incident.

The command and control structure is made up of 2 tiers:

  1. The GM Hospital Cell which is responsible for the strategic response to COVID across GM and;
  2. GM Gold Command which is responsible for managing the operational response to the pandemic across GM including the provision of mutual aid.

Each organisation within GM also has an established command and control structure. Gold Command is accountable for the overall management of the event, formulating a strategy to respond to the incident. GM Gold Command is the decision making body responsible for providing a co-ordinated approach across the organisations and delegating actions to the individual command levels.

I was deployed into the system to provide PMO support to GM Gold Command and respective Provider Executive Director Groups. This is where I experienced my first encounter of the severity of this virus; I was shocked at the scale of the problem facing the health and care sector. It was unprecedented in terms of the number of people affected and the levels of admissions each hospital was dealing with as a result.

Following the Manchester Arena incident, GM had processes and structures in place to prepare for future potential emergencies. However, nobody across the country was able to predict the scale of Covid-19, particularly the amount of consumables they would require; such as PPE, which is designed to help protect an individual and prevent the spread of infection. The supply of PPE was a significant challenge nationally; it was interesting to hear Gold Command discuss strategies to resolve the issue, particularly how organisations offered mutual support to one another. GM adapted their approach and worked with the independent sector and local communities, to form an integrated environment ensuring all organisations were supported.

The Executive Director Groups are responsible for reviewing activity across GM and producing escalation plans for their individual areas for example Workforce, Finance, Estates and Operations. During meetings with the Executive Director Groups, it was also clear that there were people personally affected by the loss of colleagues from their own organisations, which I was saddened to hear of.

The Infection Prevention Control (IPC) guidance outlines the precautions and control measures required to manage and prevent transmission of the infection. This guidance had significant influence on the organisational infrastructure; it was used to develop approaches for patient placement settings, testing and visiting policies. Another key aspect under national guidance is staff; certain groups were classed as more vulnerable such as those from a Black and Minority Ethnic (BAME) background, hospital trusts expressed the importance of ensuring all staff have risk assessments in place. As an individual from a BAME background I was pleased to hear the risk assessment was guided by the welfare of all staff and not by background; all individuals are vulnerable and at risk regardless of ethnicity.

Following risk assessments vulnerable staff were enabled to shield at home. This impacted resources and the management of patients; however systems were introduced to create a ‘virtual setting’ which is fascinating. Despite living in an environment where technology is valued I had my concerns. The system was piloted on a respiratory ward; staff could communicate with patients through devices and had the ability to track patient progress through an automated system and could see at a glance where action is required. Patient care still remained the main focus, often saving valuable time and duplication for the staff.

As a resident of GM, although we are in unprecedented times, I feel comfortable knowing I live in a region where protecting the people in the GM footprint is the main focus, and where volunteers, charities, independent sectors, in hospital, out of hospital, and wider Health and Social Care staff have all come together to mutually support each other.

Moving into the recovery phase it was rewarding to see the difference the response phase had made. There were reductions in infection rates, teams were developing plans to reintroduce elective work, hospitals reviewed ward areas conforming to national guidance and effectively plan demand and capacity.

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