Lockdown, leadership and the road to recovery

Alison writes:

Taking on my first management and nurse lead role at the Rheumatology Department in Salisbury ten years ago has definitely been full of ups and downs but nothing quite like the rollercoaster of the past 6 months!

One of our trust values at Salisbury NHS Foundation Trust is Responsive; being able to react quickly and positively, offering a flexible service. Well never has the department had to be quite this flexible!

At 8.30pm on 23rd March, Prime Minister Boris Johnson made an unprecedented address to the nation announcing the beginning of lockdown, and for many, the face of our service changed overnight.

A department normally busy with patients fell quiet as all consultations, other than urgent, were conducted over the telephone- a new way of working and communicating with our patients. The advice line, always an important service for the patients suddenly went crazy. We went from manning the telephone for 3 hours each working day to it being open all day every day except Sunday. People were understandably concerned about their conditions, treatments and their risk of contracting COVID -19.

Responding to the challenges of offering our service in a different way, I found my leadership style shifting slightly from one of facilitation to one more directional. It was important to support the team through the huge changes including staff shielding, accommodating working from home, departmental social distancing and more recently, the slow introduction of more face-to-face appointments taking place.

Not only has it been important to support the patient’s expectations during this time but also the staff who suffered with the uncertainty of the situation and the constant changes that we brought in frequently. Team communication was vital and one way we supported this was by forming a team WhatsApp group named ‘chat rheum’. It worked so well, especially during the height of the pandemic when things changed daily.

As a department we were fortunate as none of our nurses were redeployed, although all were ready to go and the consultants were only needed for a short period so we were able to remain open as a service throughout lockdown and now we are starting on the road to recovery.

The advice line has gone from worries about COVID to worries about conditions. Many patients managed throughout lockdown but now want and need to be seen again. We are slowly opening up to more face-to-face consultations, especially for urgent referrals and those patients experiencing flares, but about 60% still remain telephone consultations and I feel this will be our new normal.

The resilience and responsiveness of the Rheumatology team at Salisbury has been challenged more than ever before but we all rode the roller coaster together, supporting, communicating and caring for our patients and colleagues. We were in it together!