The work was done across inpatient Rehabilitation Service in Cwm Taf Morgannwg University Health Board (CTMUHB), South Wales covering the areas of Bridgend, Rhondda Taf Ely, and Merthyr Cynon valleys. The team involved consisted of senior members of the Multidisciplinary Team across three inpatient rehabilitation units. The target audience were the wider junior members of the Rehabilitation service.

Issues

• Quickly and effectively respond to a rapidly evolving scenario.

• Provide leadership and direction in unknown and unprecedented scenario.

• ‘Lockdown’ a service providing mental health care for a complex group of patients.

• Keep units infection free.

• ‘Shield’ clinically vulnerable patients at high risk of fatality.

• Reassure and support anxious staff and patients.

• Maintain services during times of high staff sickness.

IssuesThe cause of the challenge was monitored via daily Government briefings, Daily CTMUHB updates and keeping updated with Public Health Wales Guidance. A weekly planner was disseminated to the lead members of the Covid 19 team, then cascaded to the remainder of the teams with all issues identified and clear action plan outlined in a table format.

The weekly Covid 19 planner was adopted by all three units and disseminated quickly after each weekly meeting. Consistency across the units meant that if staff needed to relocate due to the high sickness rate, they knew the plans in place. Patients adapted to the pandemic well with no critical incidents. There were no shortages of drugs or PPE because planning began well in advance of the Pandemic peak. Throughout the first wave of the pandemic, we had only one patient who tested positive who was rapidly identified and hospitalised. Staff felt supported and anxiety reduced due to clear plans being formulated.

We learned that in highly stressful circumstances such as the Covid Pandemic, a different leadership style is required; one which is flexible, creative and more assertive.