Airdrie & Coatbridge Advertiser
‘Suddenly it became very real for us’
Covid was a real baptism of fire for NHS Lanarkshire’s chief executive
First she was acting chief executive, then interim chief executive before finally, in October 2020, Heather Knox became NHS Lanarkshire’s permanent chief executive.
In February 2020 she first stepped in for Calum Campbell who had been called in to assist at NHS Greater Glasgow and Clyde before he eventually moved east to take up a new role with NHS Lothian.
At the time, coronavirus was spreading rapidly and would soon reach Scotland, meaning a baptism of fire for Heather.
“We were receiving news of widespread outbreaks of Covid in Italy and we heard the reports from Wuhan but I think everybody at that time thought it would still be contained,” said Heather.
“In Lanarkshire we were co-ordinating several incident support teams to contact trace locally.
“We went quite quickly from it feeling like something that was over in Wuhan, maybe a few cases in Scotland, issues in Italy and suddenly it became very real for us.
“I sat down with each of my divisional leads to review in detail our existing resilience plans. We went through them and considered the specific implications of a virus such as Covid.
“The particular areas of focus in those early days were really around ensuring our ability to rapidly upscale critical care, to make sure we had enough beds to cope because I was absolutely determined that I was not going to run out of beds and we engaged our resilience partners across the local authorities to plan mutual aid.”
As the crisis progressed, support from North and South Lanarkshire councils was key as the health board entered an emergency command situation.
That saw daily meetings between senior managers and tactical groups set up to cover different areas of the response including an ehealth digital group to bring in online working.
Key decisions in clinical services such as how to plan for trauma provision, general surgery and emergency services were made and the board’s mobilisation plan was written as requested by the Scottish Government.
Heather added: “They were requesting a lot of detail and this was all new.
“The 10 weeks following on from that initial mobilisation phase were very demanding, personally and professionally. I lost some family early on in the outbreak and that was difficult. At the same time, there was an outbreak within Kirklands [hospital, Bothwell], so we had a number of senior staff who were being tested.
“You had to almost compartmentalise your concerns about direct members of staff and put that to one side and focus on responding and mobilising rapidly.
“There has been a lot of learning and I think that we know we can recognise when we need support as leaders and that our staff also need support.
“We have done a huge amount of work on staff wellbeing. Our staff have been absolutely fantastic throughout this pandemic.”
Despite the need to cancel a number of operations and appointments so hospitals could cope with the volume of Covid patients, NHS Lanarkshire remained open for emergency care and outpatient services.
Heather added: “We’ve actually kept most of our outpatient services going, strange as that may seem, but the benefits of digital technology have enabled us to do a lot of remote consultation.
“We’ve also used the Louisa Jordan [hospital] for face-to-face [meetings] when we couldn’t see people.
“It has been more an issue around our inpatient planned operations where we’ve had to have that conversation with people to say we will get to you.
“We have continued right the way through doing our urgent work and our cancer work and we are now beginning slowly to bring back up that elective care programme. We’ve just started to write to all our patients that are on our waiting list explaining how that will be worked through.
“How have people taken it? I think people have been generally understanding. I haven’t had a massive mailbox of complaints from people about routine work.”
However, Heather is anxious over the amount of work the health board hasn’t been able to do and she wants everyone to know that they are still open for anyone who needs them.
She added: “I’m also quite concerned about the fact that we have delayed so much work and I do worry that a number of these people may now present as emergencies.
“I think people were scared to come into hospital as well at the beginning and some people should have come to see us sooner.
“One of the messages is that our emergency care services remain open and if you are concerned, we have got safety provision in the hospital.
“Do come forward if you are concerned and you think you have an emergency.”
A significant milestone was reached last week as NHS Lanarkshire hit the 250,000 mark for first doses of the coronavirus vaccination.
Over the course of the coming months, the health board will deliver one million vaccination doses across the county – two each for all 500,000 adults.
“I’m really proud of what the team have achieved,” Heather said. “We’ve passed a landmark and we are now half way through the first doses.
“We are well on track and I think we will be down to the end of the Joint Committee on Vaccination and Immunisation cohort nine by the end of March.
“The target nationally is mid-april so if vaccine supply is still forthcoming, and we think it will be for the next few weeks, we should be one of the first boards in Scotland to get to our target.”
There is now light at the end of the tunnel after a hard year and Heather is feeling more positive about what is to come.
“I think we have coped well,” she added. “But I think that’s because we have such fantastic staff. Our workforce have gone above and beyond every day.
“It’s not over yet but I do now feel a lot more optimistic about the future.”
Turn to pages eight and nine for a reflection on a year of Covid in Monklands.